Individual
KELLI MICHELLE CANNATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8290 UNIVERSITY AVE NE, STE 200, FRIDLEY, MN 55432-1847
(763) 786-9543
(763) 786-3320
Mailing address
8290 UNIVERSITY AVE NE, STE 200, FRIDLEY, MN 55432-1847
(763) 786-9543
(763) 786-3320
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12312
MN
Other
Enumeration date
06/28/2016
Last updated
10/07/2019
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