Kimberly Dawn Bleasdale, PA-C
Physician Assistant in New Hope, MN. Individual provider (NPI-1).
NPI number1790787745
StatusActive
Last updated in NPPESMay 18, 2015
Details
- NPI
- 1790787745
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kimberly Dawn Bleasdale
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 2, 2005
- Last updated
- May 18, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 10493 | MN | Yes |
Other names
- Kimberly Dawn Petryszyn (Former Name)
Practice location
8301 47th Ave NNew Hope, MN 55428-4512
Phone 763-504-4935 · Fax 763-504-4932
Mailing address
8301 47th Ave NNew Hope, MN 55428-4512
Phone 763-504-4935 · Fax 763-504-4932
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