Kelly L Dziedzic in Burnsville - Physician Assistant
Kelly L Dziedzic - NPI 1568437879
Kelly L Dziedzic is a Physician Assistant in Burnsville, Minnesota. Kelly L Dziedzic practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kelly L Dziedzic is 1568437879. The last update date is 2019-01-02.
Kelly L Dziedzic's current location address is 1000 W 140th St Unit 201, Burnsville, Minnesota. You can contact this provider via phone number 9528083000 and fax number 9528083001. The mailing address for Kelly L Dziedzic is 1000 W 140th St Unit 201, Burnsville, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly L Dziedzic |
|---|---|
| Address | 1000 W 140th St Unit 201, Burnsville, Minnesota |
| Phone Number | 9528083000 |
| Fax Number | 9528083001 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1568437879 |
|---|---|
| Provider Enumeration Date | 2006-02-21 |
| Last Updated Date | 2019-01-02 |
Provider Mailing Address Detail
| Address | 1000 W 140th St Unit 201 |
|---|---|
| City | Burnsville |
| State | Minnesota (MN) |
| Post Code | 553374833 |
| Phone Number | 9528083000 |
| Fax Number | 9528083001 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 9792 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 205559700 | MN | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Kelly L Dziedzic?
The Kelly L Dziedzic has been issued the NPI (National Provider Identifier) 1568437879 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Kelly L Dziedzic is physically located?
The Kelly L Dziedzic is physically situated at the following address: 1000 W 140Th St Unit 201, Burnsville, MN, 553374833.
What is Kelly L Dziedzic's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kelly L Dziedzic's area of specialization is Physician Assistant, and the corresponding taxonomy code that categorizes this field of practice is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1568437879 to Kelly L Dziedzic?
The Kelly L Dziedzic received its 1568437879 assignment from the Centers for Medicare & Medicaid Services on 2006-02-21.
As of what date was the information regarding Kelly L Dziedzic, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Kelly L Dziedzic, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2019-01-02.