IndividualActive
Ethan Conroy, PAC
NPI 1023089547 · Surgical Physician Assistant · Saint Paul, MN
Provider details
- NPI number
- 1023089547
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- License
- 9849 (MN)
Practice location
17 Exchange St W
Suite 222
Saint Paul, MN 55102-1045
Phone: (651) 224-7854
Mailing address
1516 Holton St
Saint Paul, MN 55108-2326
Registry dates
- Enumerated
- 2006-02-01
- Last updated
- 2014-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.