Conroy, Ethan

Conroy, Ethan is an individual health care provider with primary practice located at 17 Exchange St W Suite 222, Saint Paul MN 55102-1045. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Conroy, Ethan can be contacted via phone (651) 224-7854.

Contact Information

Primary practice address
17 Exchange St W Suite 222 Saint Paul MN 55102-1045
Phone: (651) 224-7854
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 9849 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 9849 Minnesota

Profile Details

NPI number 1023089547
LBN Legal business name Conroy, Ethan
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated Oct 30th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023089547 NPPES
Minnesota MEDICAID 923192700

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