Provider Demographics
NPI:1639510795
Name:FASCHING, MEGAN E (PA-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:FASCHING
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:9825 HOSPITAL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4479
Mailing Address - Country:US
Mailing Address - Phone:763-780-6699
Mailing Address - Fax:763-420-0506
Practice Address - Street 1:9825 HOSPITAL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4479
Practice Address - Country:US
Practice Address - Phone:763-780-6699
Practice Address - Fax:763-420-0506
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2016-09-09
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Provider Licenses
StateLicense IDTaxonomies
MN1931363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical