Basic Information
| Provider Information | |||||||||
| NPI: | 1174695464 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINIBALDI | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 CARLSON PKWY N | ||||||||
| Address2: | STE 240 | ||||||||
| City: | PLYMOUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554474485 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7637460030 | ||||||||
| FaxNumber: | 7633677977 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 CHESTERFIELD PKWY E | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630172167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3148783839 | ||||||||
| FaxNumber: | 3148786575 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2006 | ||||||||
| LastUpdateDate: | 10/31/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2013037117 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.