Healthcare Provider Details

I. General information

NPI: 1740951227
Provider Name (Legal Business Name): AMBER DARLENE MCDONALD PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER IGNASZEWSKI

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 WOODWINDS DR
WOODBURY MN
55125-4445
US

IV. Provider business mailing address

1700 UNIVERSITY AVE W FL 6
SAINT PAUL MN
55104-3727
US

V. Phone/Fax

Practice location:
  • Phone: 651-232-0228
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number14746
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA16298
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: