NEA RAE BENNINGTON

ST LOUIS PARK, MN
NPI1205277571
Former NameNEA RAE HARKNESS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MN  11384)
Enumeration Date2013-07-15
Last Update Date2022-05-12
Business Address
NEA RAE BENNINGTON PA-C
3931 LOUISIANA AVE S
ST LOUIS PARK, MN 55426-5000
Phone number: 952-993-3230
Mailing Address
NEA RAE BENNINGTON PA-C
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 55425-4516
Phone number: