Individual provider · Type 1 NPI
Luke A. Herdina, P.A.-C
Medical Physician Assistant · Big Lake, MN
NPI number
1720118912
Active
Practice location
16830 198th Ave NW, Big Lake Clinic
Big Lake, MN 55309
Mailing address
P.o. Box 539, 16830 198th Ave NW Big Lake Clinic
Big Lake, MN 55309
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0630 (SD) |
| Medical Physician Assistant Primary | 363AM0700X | 1259 (MN) |
Medical Physician Assistant: Definition to come...
5 other providers at this address
- Centracare ClinicMulti-Specialty Clinic/Center Big Lake, MN NPI 1013104348
- Fresenius Medical Care Centracare Dialysis, LLCEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center Big Lake, MN NPI 1972278810
- Glenn W. Weidenbacher, MDPediatrics Physician Big Lake, MN NPI 1801873674
- Lola B. Sutherland, MDFamily Medicine Physician Big Lake, MN NPI 1417924994
- Nabeel Bishara Ailabouni, DOFamily Medicine Physician Big Lake, MN NPI 1043479876
About NPI 1720118912
Luke A. Herdina, P.A.-C's National Provider Identifier is 1720118912, issued on Mar 6, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Big Lake, MN. The record was last updated on May 5, 2009.