Healthcare Provider Details

I. General information

NPI: 1356431803
Provider Name (Legal Business Name): DAWN RAMALEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 ELM STREET
ANNANDALE MN
55302
US

IV. Provider business mailing address

9314 SYCAMORE CT N
MAPLE GROVE MN
55369-7116
US

V. Phone/Fax

Practice location:
  • Phone: 320-274-3744
  • Fax: 320-274-8194
Mailing address:
  • Phone: 763-416-6156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number9345
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: