Healthcare Provider Details

I. General information

NPI: 1326304700
Provider Name (Legal Business Name): AMY MARIE DALASKA MONSOUR CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 VERMILLION ST
HASTINGS MN
55033-2844
US

IV. Provider business mailing address

1411 VERMILLION ST
HASTINGS MN
55033-2844
US

V. Phone/Fax

Practice location:
  • Phone: 651-438-2200
  • Fax:
Mailing address:
  • Phone: 651-438-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP9746
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: