Healthcare Provider Details

I. General information

NPI: 1881903524
Provider Name (Legal Business Name): DENISE M ABRAHAMSON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 BELLE AVE
MANKATO MN
56001-5250
US

IV. Provider business mailing address

605 HILLCREST AVE SUITE 130
OWATONNA MN
55060-3680
US

V. Phone/Fax

Practice location:
  • Phone: 507-344-8698
  • Fax: 507-344-8759
Mailing address:
  • Phone: 507-451-0290
  • Fax: 507-451-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL033268-4
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: