Individual
ERIN MARIE PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
251 COUNTY ROAD 120, SAINT CLOUD, MN 56303-4872
(320) 529-4687
Mailing address
251 COUNTY ROAD 120, SAINT CLOUD, MN 56303-4872
(320) 202-8949
(320) 202-0756
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1491
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669781381
—
MN
Enumeration date
09/29/2010
Last updated
03/29/2023
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