Healthcare Provider Details

I. General information

NPI: 1386577260
Provider Name (Legal Business Name): DEBORAH DANIELLE LOMMEL DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11550 ARBOR LAKES PKWY N UNIT 1169
MAPLE GROVE MN
55369-2242
US

IV. Provider business mailing address

11550 ARBOR LAKES PKWY N UNIT 1169
MAPLE GROVE MN
55369-2242
US

V. Phone/Fax

Practice location:
  • Phone: 612-865-5599
  • Fax:
Mailing address:
  • Phone: 612-865-5599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2495763
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: