Healthcare Provider Details

I. General information

NPI: 1649415993
Provider Name (Legal Business Name): DIANE K HOESE CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 FORD AVE N MCLEOD CTY PUBLIC HEALTH, SUITE 200
GLENCOE MN
55336-1363
US

IV. Provider business mailing address

1805 FORD AVE N MCLEOD CTY PUBLIC HEALTH, SUITE 200
GLENCOE MN
55336-1363
US

V. Phone/Fax

Practice location:
  • Phone: 320-864-3185
  • Fax: 320-864-1484
Mailing address:
  • Phone: 320-864-3185
  • Fax: 320-864-1484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberR0785150
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: