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NPI Code Detail

MEDICARE: CATHY RESNICK SACKETT WHNP

MEDICARE:   CATHY RESNICK SACKETT  WHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerR0993997MN

General Provider Information

NPI Number : 1861464042
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHY RESNICK SACKETT WHNP
Provider Business Mailing Address
First Line : 8100 34TH AVE S
Second Line : 21110Q
City : BLOOMINGTON
State : MN
Zip : 55425-1672
Country : US
Telephone Number : 952-883-7961
Fax Number : 952-883-5395
Provider Business Practice Location Address
First Line : 6845 LEE AVE N
Second Line : MAIL STOP 31400A
City : BROOKLYN CENTER
State : MN
Zip : 55429-1717
Country : US
Telephone Number : 763-569-0300
Fax Number : 763-569-0311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 07/08/2007

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Directions to “ CATHY RESNICK SACKETT WHNP” Practice Location

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