Individual
MS. ALISSA S VENTURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9825 HOSPITAL DR STE 105, MAPLE GROVE, MN 55369-4769
(763) 780-6699
(763) 420-0500
Mailing address
9825 HOSPITAL DR, STE 105, MAPLE GROVE, MN 55369-4479
(763) 780-6699
(763) 420-0500
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9911
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078475300
—
MN
Enumeration date
02/22/2006
Last updated
12/04/2019
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