Abraham, Eliza Anderson

Abraham, Eliza Anderson is an individual health care provider with primary practice located at 4480 Centerville Rd , White Bear Lake MN 55127. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Abraham, Eliza Anderson can be contacted via phone (651) 484-2724.

Contact Information

Primary practice address
4480 Centerville Rd White Bear Lake MN 55127
Phone: (651) 484-2724
Fax: (651) 484-2723
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 14153 Minnesota

Profile Details

NPI number 1699437145
LBN Legal business name Abraham, Eliza Anderson
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2021
Last updated Oct 14th, 2022 - about 4 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 1699437145 NPPES
Minnesota Other 14153 MN LICENSE

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