Individual
ERICA L DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
(218) 546-4400
Mailing address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
(218) 546-4400
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
13557
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13557
LICENSE
MN
Enumeration date
01/06/2021
Last updated
01/06/2021
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