Provider Demographics
NPI:1356431803
Name:RAMALEY, DAWN (PA-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:RAMALEY
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 1:9314 SYCAMORE CT N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-7116
Mailing Address - Country:US
Mailing Address - Phone:763-416-6156
Mailing Address - Fax:
Practice Address - Street 1:440 ELM STREET
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:MN
Practice Address - Zip Code:55302
Practice Address - Country:US
Practice Address - Phone:320-274-3744
Practice Address - Fax:320-274-8194
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9345363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical