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Individual

DENISE L ROUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-8000
Mailing address
342 13TH AVE NE, MINNEAPOLIS, MN 55413-1265
(651) 588-9411

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10814
MN
363A00000X
Physician Assistant
PA-890
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432142899
ME
Enumeration date
09/20/2006
Last updated
04/10/2015
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