Individual
MRS. KIMBERLY ELLIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2621 GREENHAVEN RD, ANOKA, MN 55303
(763) 587-4488
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11703
MN
Other
Enumeration date
09/19/2014
Last updated
02/06/2025
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