Provider Demographics
NPI:1053510842
Name:PASEKA, GINA RUTH FIGI (PA)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:RUTH FIGI
Last Name:PASEKA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:R FIGI
Other - Last Name:PASEKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:P.O. BOX 1450, NW 6035
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55485-6035
Mailing Address - Country:US
Mailing Address - Phone:952-738-4456
Mailing Address - Fax:952-738-4438
Practice Address - Street 1:5775 WAYZATA BOULEVARD
Practice Address - Street 2:SUITE 150
Practice Address - City:ST. LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2698
Practice Address - Country:US
Practice Address - Phone:952-738-4488
Practice Address - Fax:952-543-6524
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10294363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN10294OtherPHYSICIAN ASSISTANT LICENSE