| Noune Petrosian, PAC | |
|
508 Tenth Street, Worthington, MN 56187-2343 | |
| (507) 372-2921 | |
| (507) 372-1815 |
| Full Name | Noune Petrosian |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Surgical |
| Location | 508 Tenth Street, Worthington, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013003706 | NPI | - | NPPES |
| 132167 | Other | MN | UCARE |
| P00314620 | Other | MN | RR MEDICARE |
| 877938400 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | 9885 (Minnesota) | Primary |
| Entity Name | Divine Medical Wellness Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972920098 PECOS PAC ID: 2264787621 Enrollment ID: O20180626002778 |
| Mailing Address | Practice Location Address |
|---|---|
| Noune Petrosian, PAC 508 Tenth Street, Worthington, MN 56187-2343 Ph: (507) 372-2921 | Noune Petrosian, PAC 508 Tenth Street, Worthington, MN 56187-2343 Ph: (507) 372-2921 |
Mrs. Lisa Rae Milbrandt, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1680 Diagonal Rd, Worthington, MN 56187 Phone: 507-360-8825 |
Anneke Marie Hurley, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1680 Diagonal Rd, Worthington, MN 56187 Phone: 507-372-3800 |
William James Rodney Nelson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1680 Diagonal Rd, Worthington, MN 56187 Phone: 507-372-3800 |
Brennan Huwe, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1680 Diagonal Rd, Worthington, MN 56187 Phone: 507-372-3800 |
Ryan Willems, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1216 Ryans Rd, Suite 1, Worthington, MN 56187 Phone: 507-372-2921 Fax: 507-372-5789 |
Megan Meinders, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1680 Diagonal Rd, Worthington, MN 56187 Phone: 507-372-3800 |
Alettie Jane Lewis, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1680 Diagonal Rd, Worthington, MN 56187 Phone: 507-372-3800 |