Provider Demographics
NPI:1639552706
Name:JOSHI, DEANNA LOCURTO (PA-C)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:LOCURTO
Last Name:JOSHI
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 1:11850 BLACKFOOT ST NW STE 300
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2772
Mailing Address - Country:US
Mailing Address - Phone:763-236-9000
Mailing Address - Fax:
Practice Address - Street 1:11850 BLACKFOOT ST NW STE 300
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2772
Practice Address - Country:US
Practice Address - Phone:763-236-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA8124363AM0700X
MN14987363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical