Individual
JANELLE HARDISTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 2ND AVE S, STE 400, MINNEAPOLIS, MN 55402-3318
(612) 225-1538
(612) 225-1591
Mailing address
920 2ND AVE S, STE 400, MINNEAPOLIS, MN 55402-3318
(612) 225-1538
(612) 225-1591
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04170
TX
Other
Enumeration date
08/26/2009
Last updated
08/26/2009
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