Individual
MARY C ASCHENBRENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
215 RADIO DR STE 100, WOODBURY, MN 55125-5817
(612) 596-6187
Mailing address
215 RADIO DR STE 100, WOODBURY, MN 55125-5817
(612) 596-6187
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9376
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195188200
—
MN
Enumeration date
03/16/2006
Last updated
09/03/2020
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