Healthcare Provider Details

I. General information

NPI: 1942421714
Provider Name (Legal Business Name): KAREN K MASCHKA ROPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 10/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 EXCHANGE ST W STE 307
SAINT PAUL MN
55102-1223
US

IV. Provider business mailing address

PO BOX 86 SDS 12 2901
MINNEAPOLIS MN
55486-2901
US

V. Phone/Fax

Practice location:
  • Phone: 651-842-5200
  • Fax: 651-223-5903
Mailing address:
  • Phone: 651-968-5050
  • Fax: 651-968-5900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number8957
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: