Most Relevant Information
Provider Data
| NPI Number: | 1003337601 |
| Provider Name: | AMY VANDENBERG PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/05/2017 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
3850 PARK NICOLLET BLVD
ST LOUIS PARK
MN
554162527
Practice Location Phone/Fax
| Phone: | 9528831000 |
| Fax: |
Provider Mailing Location
8170 33RD AVE S # MS 21110Q
BLOOMINGTON
MN
554254516
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |