Dziedzic, Kelly L

Dziedzic, Kelly L is an individual health care provider with primary practice located at 1000 W 140Th St Unit 201 , Burnsville MN 55337-4833. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Dziedzic, Kelly L can be contacted via phone (952) 808-3000.

Contact Information

Primary practice address
1000 W 140Th St Unit 201 Burnsville MN 55337-4833
Phone: (952) 808-3000
Fax: (952) 808-3001
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9792 Minnesota

Profile Details

NPI number 1568437879
LBN Legal business name Dziedzic, Kelly L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Jan 2nd, 2019 - about 5 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 1568437879 NPPES
Minnesota MEDICAID 205559700

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