Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miranda Marie Lacroix, PA-STUDENT

Individual provider Physician Assistant · NPI 1942815980

Miranda Marie Lacroix, PA-STUDENT is a Physician Assistant in Saint Paul, Minnesota. Qualified in 2021, 5 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
5
Licensed in
MN
In the registry since
2020
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Practice location Address checks out

640 Jackson St
Saint Paul, MN 55101-2502
Phone: (651) 254-3456
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1204 Black Oak Dr, New Brighton, MN 55112-8432 — (920) 242-3001

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 13913 (MN)

Record details

NPI number1942815980
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-STUDENT
Sole proprietorNo
NPI enumeratedSeptember 15, 2020
Last updated in NPPESDecember 6, 2021
Certification dateDecember 6, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Saint Paul