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Adult Health Nurse Practitioner

NPI: 1316313562IndividualAccepts Medicare

Specialties, Licenses & Credentials

Home Health Registered Nurse

Registered Nurse — Home Health

Code: 163WH0200X

R191271-5(MN)
Gerontology Nurse Practitioner

Nurse Practitioner — Gerontology

Code: 363LG0600X

CNP5148(MN)
Primary Care Nurse Practitioner

Nurse Practitioner — Primary Care

Code: 363LP2300X

CNP5148(MN)
Adult Health Nurse PractitionerPrimary

Nurse Practitioner — Adult Health

Code: 363LA2200X

CNP5148(MN)

CMS Specialties

PrimaryNURSE PRACTITIONER

Education

OTHER

Class of 2014

Contact & Hours

Via practice · 2 locations total

Address
856 UNIVERSITY AVE W
SAINT PAUL, MN 55104

Locations (2)

Practice Location

856 UNIVERSITY AVE W, SAINT PAUL, MN
(651) 665-9795

Practice Location

49725 COUNTY 83, STAPLES, MN
(218) 894-1515

Quick Facts

NPI
1316313562
Entity Type
Individual
Gender
Male
Medicare
Accepted
Specialties
4
Locations
2
Years in Practice
12

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