Individual
HEIDI M THORESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
920 4TH AVE SW, PIPESTONE, MN 56164-1455
(507) 825-5700
(507) 825-4752
Mailing address
920 4TH AVE SW, PIPESTONE, MN 56164-1455
(507) 825-5700
(507) 825-4752
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10239
LICENSE
MN
05
—
128473000
—
MN
Enumeration date
01/08/2007
Last updated
09/27/2013
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