Individual
LORI M METZGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A..-C.
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-1809
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-1809
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10452
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750537809
—
MN
01
—
970003679
MEDICARE-PTAN
MN
Enumeration date
08/08/2008
Last updated
06/04/2014
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