Grandia, Connie Marie

Grandia, Connie Marie is an individual health care provider with primary practice located at 134 Southview St , Owatonna MN 55060-3241. 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. Grandia, Connie Marie can be contacted via phone (507) 451-1120.

Contact Information

Primary practice address
134 Southview St Owatonna MN 55060-3241
Phone: (507) 451-1120
Fax: (507) 444-6287
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9651 Minnesota

Profile Details

NPI number 1699796052
LBN Legal business name Grandia, Connie Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Oct 28th, 2008 - about 16 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 1699796052 NPPES
Minnesota MEDICAID 767608500

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