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NPI Code Detail

MEDICARE: ALLISON RAE BURGSTAHLER PA

MEDICARE: ALLISON RAE BURGSTAHLER PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant13528MN
2363A00000XPhysician Assistant1144787680

General Provider Information

NPI Number : 1144787680
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON RAE BURGSTAHLER PA
Provider Business Mailing Address
First Line : 2925 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1321
Country : US
Telephone Number : 612-262-9000
Fax Number :
Provider Business Practice Location Address
First Line : 800 E 28TH ST STE 401
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-3723
Country : US
Telephone Number : 612-863-0200
Fax Number : 612-863-0235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2019
Last Update Date : 12/05/2025

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Directions to “ ALLISON RAE BURGSTAHLER PA” Practice Location

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