Healthcare Provider Details

I. General information

NPI: 1518875731
Provider Name (Legal Business Name): ADESSA RAE BENTLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADESSA RAE FISCHER

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MINNEAPOLIS AVE
DULUTH MN
55803-2017
US

IV. Provider business mailing address

6 MINNEAPOLIS AVE
DULUTH MN
55803-2017
US

V. Phone/Fax

Practice location:
  • Phone: 218-200-9483
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1996744
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: