Provider Demographics
NPI:1457721326
Name:FROYUM, KATLYN (PA-C)
Entity Type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:FROYUM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2550 UNIVERSITY AVE W STE 110N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-2001
Mailing Address - Country:US
Mailing Address - Phone:651-602-5309
Mailing Address - Fax:
Practice Address - Street 1:7760 FRANCE AVE S STE 1000
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55435-5870
Practice Address - Country:US
Practice Address - Phone:952-746-6767
Practice Address - Fax:952-746-6768
Is Sole Proprietor?:No
Enumeration Date:2015-10-04
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN11945363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant