Provider Demographics
NPI:1295628212
Name:MAGNIN, PAYTON A (PA)
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:A
Last Name:MAGNIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 LILY POND LN
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-6137
Mailing Address - Country:US
Mailing Address - Phone:651-728-1583
Mailing Address - Fax:
Practice Address - Street 1:296 LILY POND LN
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55127-6137
Practice Address - Country:US
Practice Address - Phone:651-728-1583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant