Provider Demographics
NPI:1235829474
Name:MONSON SLAGLE, ANN MARIE (PA-C)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:MONSON SLAGLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1811 WEIR DR STE 270
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-6741
Mailing Address - Country:US
Mailing Address - Phone:651-714-9646
Mailing Address - Fax:
Practice Address - Street 1:1811 WEIR DR STE 270
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-6741
Practice Address - Country:US
Practice Address - Phone:651-243-6087
Practice Address - Fax:651-714-9647
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9117726363A00000X
MN14759363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant