Provider Demographics
NPI:1972070019
Name:BROWN, ANA ROSE (PA-C)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ROSE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:ROSE
Other - Last Name:ZDECHLIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:542 TOMLYN AVE
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-6013
Mailing Address - Country:US
Mailing Address - Phone:651-500-2967
Mailing Address - Fax:
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-581-2800
Practice Address - Fax:763-581-2801
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12826363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant