Provider Demographics
NPI:1104445881
Name:HARPOLE, ELLA TREPASHKO (PA)
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:TREPASHKO
Last Name:HARPOLE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2854 HIGHWAY 55 STE 130
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-1447
Mailing Address - Country:US
Mailing Address - Phone:651-842-3329
Mailing Address - Fax:651-842-3391
Practice Address - Street 1:1997 SLOAN PL STE 17
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55117-2051
Practice Address - Country:US
Practice Address - Phone:651-772-6251
Practice Address - Fax:651-294-9661
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN4371133V00000X
MN13298363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered