Individual provider · NPI-1

Mikaela Hartzler Keating, PA-C

Physician Assistant, Medical · Robbinsdale, MN

NPI number1194423285
StatusActive
Last updated in NPPESDec 7, 2023

Details

NPI
1194423285
Entity type
Individual (NPI-1)
Name
Mikaela Hartzler Keating
Credential
PA-C
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 20, 2023
Certification date
Dec 7, 2023
Last updated
Dec 7, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AM0700X Physician Assistant, Medical14391MNYes
208M00000X Hospitalist14391MN

Practice location

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Phone 763-520-5200

Mailing address

750 Otto Ave Unit 2242
Saint Paul, MN 55102-5042

Phone 651-315-6190

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