Individual provider · Type 1 NPI

Erin Joy De la Bruere, PA

Physician Assistant · Roseville, MN

NPI number 1619625639 Active

Practice location

2720 Fairview Ave N Ste 200
Roseville, MN 55113-1306

Call (651) 663-6883 Map

Mailing address

16333 E Lake Netta Dr NE
Ham Lake, MN 55304-5126

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X14068 (MN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1619625639

Erin Joy De la Bruere, PA's National Provider Identifier is 1619625639, issued on Mar 17, 2022. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Roseville, MN. The record was last updated on Oct 16, 2026.