Individual provider · Type 1 NPI

Tatiana Mudrenko, PA

Surgical Physician Assistant · Roseville, CA

NPI number 1417513490 Active

Practice location

1600 Eureka Rd
Roseville, CA 95661-3027

Mailing address

2555 Newcastle Rd
Newcastle, CA 95658-9751

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1417513490

Tatiana Mudrenko, PA's National Provider Identifier is 1417513490, issued on May 15, 2019. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Roseville, CA. The record was last updated on Jan 11, 2022.