Individual
MINDY LOUANN ELLIASON OSLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101
(651) 254-3456
(651) 254-9673
Mailing address
8170 33RD AVE, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10079
MN
363A00000X
Physician Assistant
PA1005038
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
01/23/2006
Last updated
08/16/2022
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