ELIZA ANDERSON ABRAHAM PA-C NPI 1699437145

NPI Information

NPI: 1699437145
Provider Name: ELIZA ANDERSON ABRAHAM, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
4480 CENTERVILLE RD
WHITE BEAR LAKE, MN
ZIP 55127
Phone: (651) 484-2724
Get Directions

Eliza Anderson Abraham, PA-C is a medical physician assistant in White Bear Lake, MN with 2 years of experience. Eliza Anderson Abraham, PA-C NPI is 1699437145. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4480 CENTERVILLE RD
WHITE BEAR LAKE, MN
ZIP 55127
Phone: (651) 484-2724
Fax: (651) 484-2723

The NPI 1699437145 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/12/2021 and was last updated on 10/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	14153	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	14153	OTHER	MINNESOTA	MN LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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