Healthcare Provider Details

I. General information

NPI: 1891724696
Provider Name (Legal Business Name): JOANNE OSTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 BARRIE RD
EDINA MN
55435-2305
US

IV. Provider business mailing address

14000 NICOLLET AVE STE 304
BURNSVILLE MN
55337-5784
US

V. Phone/Fax

Practice location:
  • Phone: 952-915-6000
  • Fax: 952-915-6100
Mailing address:
  • Phone: 952-898-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: