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General NPI Number Information
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NPI Number | 1265076855
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Entity Type | Individual
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Provider Name | DREW GAURKE PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 7980 UNIVERSITY AVE NE
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City | FRIDLEY
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State | MN
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Zip | 55432-1860
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Country | US
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Telephone | 763-432-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 3950 SCOTT AVE N
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City | ROBBINSDALE
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State | MN
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Zip | 55422-2025
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Country | US
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Telephone | 815-978-2982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0110007874
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110007874
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 14312
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License Number State | MN
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