Individual
ELIZA ANDERSON ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4480 CENTERVILLE RD, WHITE BEAR LAKE, MN 55127
(651) 484-2724
(651) 484-2723
Mailing address
4480 CENTERVILLE RD, WHITE BEAR LAKE, MN 55127
(651) 484-2724
(651) 484-2723
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
14153
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14153
MN LICENSE
MN
Enumeration date
10/12/2021
Last updated
10/14/2022
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