Provider Demographics
NPI:1598358095
Name:VAN CALLIGAN, DULCEY AMAIA (PA-C)
Entity type:Individual
Prefix:
First Name:DULCEY
Middle Name:AMAIA
Last Name:VAN CALLIGAN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:DULCEY
Other - Middle Name:AMAIA
Other - Last Name:MILEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 AMERICAN BLVD W STE 300
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-4442
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5651
Practice Address - Street 1:1983 SLOAN PL STE 11
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-2004
Practice Address - Country:US
Practice Address - Phone:651-312-1620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13601363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty