Individual
VICKI LYNN NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2000 23RD ST S, SARTELL, MN 56377-4765
(320) 202-8949
Mailing address
11411 TANNER RIDGE PL, RIVERVIEW, FL 33569-6531
(563) 422-8464
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15354
MN
363AM0700X
Medical Physician Assistant
PA9116644
FL
Other
Enumeration date
05/18/2006
Last updated
04/10/2026
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