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General NPI Number Information
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NPI Number | 1639552706
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Entity Type | Individual
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Provider Name | DEANNA LOCURTO JOSHI PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 11850 BLACKFOOT ST NW STE 300
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City | COON RAPIDS
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State | MN
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Zip | 55433-2772
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Country | US
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Telephone | 763-236-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 11850 BLACKFOOT ST NW STE 300
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City | COON RAPIDS
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State | MN
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Zip | 55433-2772
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Country | US
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Telephone | 763-236-9000
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA8124
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 14987
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License Number State | MN
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