Provider Demographics
NPI:1477270197
Name:BJORGAN, YULIYA DZHOLOS (PA-C)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:DZHOLOS
Last Name:BJORGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 26TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1245
Mailing Address - Country:US
Mailing Address - Phone:612-323-9101
Mailing Address - Fax:
Practice Address - Street 1:1155 CENTRE POINTE DR STE 8
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1278
Practice Address - Country:US
Practice Address - Phone:651-461-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14255363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant