Bleasdale, Kimberly Dawn

Bleasdale, Kimberly Dawn is an individual health care provider with primary practice located at 8301 47Th Ave N , New Hope MN 55428-4512. 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. Bleasdale, Kimberly Dawn can be contacted via phone (763) 504-4935.

Contact Information

Primary practice address
8301 47Th Ave N New Hope MN 55428-4512
Phone: (763) 504-4935
Fax: (763) 504-4932
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10493 Minnesota

Profile Details

NPI number 1790787745
LBN Legal business name Bleasdale, Kimberly Dawn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2005
Last updated May 18th, 2015 - about 11 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 1790787745 NPPES
West Virginia MEDICAID 3810000864

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