Healthcare Provider Details

I. General information

NPI: 1023157492
Provider Name (Legal Business Name): NATALIE ANN ROSEN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 CHICAGO AVE
MINNEAPOLIS MN
55404-4522
US

IV. Provider business mailing address

2545 CHICAGO AVE
MINNEAPOLIS MN
55404-4522
US

V. Phone/Fax

Practice location:
  • Phone: 612-863-1940
  • Fax: 612-863-2596
Mailing address:
  • Phone: 612-863-1940
  • Fax: 612-863-2596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberR038992-5
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: