Provider Demographics
NPI:1649416025
Name:SEVENING, ADRIANA C (PA-C)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:C
Last Name:SEVENING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ADRIANA
Other - Middle Name:C
Other - Last Name:SEVENING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:4400 W ARM RD APT 217
Mailing Address - Street 2:
Mailing Address - City:SPRING PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55384-9750
Mailing Address - Country:US
Mailing Address - Phone:612-270-4595
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:608-304-5352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13392363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1081863OtherNCCPA CERTIFICATION