Individual provider · NPI-1

Donna Degracia, P.A.

Physician Assistant · Coon Rapids, MN

NPI number1629017066
StatusActive
Last updated in NPPESMar 11, 2021

Details

NPI
1629017066
Entity type
Individual (NPI-1)
Name
Donna Degracia
Credential
P.A.
Sex
Female
Sole proprietor
No
Enumeration date
Jun 4, 2006
Certification date
Mar 11, 2021
Last updated
Mar 11, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant9097MNYes
207Q00000X Family Medicine9097MN

Other names

  • Donna Sidwell (Former Name)

Practice location

9055 Springbrook Dr Nw
Coon Rapids, MN 55433-5841

Phone 763-780-9155

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321

Phone 612-262-5000

Other practice locations

10190 Baltimore St Ne
Blaine, MN 55449-5056

Phone 763-795-9363 · Fax 763-795-9364

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Physician Assistant providers in Coon Rapids, MN