Healthcare Provider Details

I. General information

NPI: 1104692714
Provider Name (Legal Business Name): ADRIENNE ELIZABETH WHELAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12932 STATE HIGHWAY 18
FINLAYSON MN
55735-9581
US

IV. Provider business mailing address

12932 STATE HIGHWAY 18
FINLAYSON MN
55735-9581
US

V. Phone/Fax

Practice location:
  • Phone: 320-385-0606
  • Fax:
Mailing address:
  • Phone: 320-385-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR1604939
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: