Provider Demographics
NPI:1922722214
Name:JOINER, KATRINA DEANE REITZ (PA-C)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:DEANE REITZ
Last Name:JOINER
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8401 GOLDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4486
Practice Address - Country:US
Practice Address - Phone:952-993-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2024-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN14234363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant