Healthcare Provider Details

I. General information

NPI: 1700984770
Provider Name (Legal Business Name): DENISE DEHN FARR CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR ROUTE 116A
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

1 VETERANS DR ROUTE 116A
MINNEAPOLIS MN
55417-2309
US

V. Phone/Fax

Practice location:
  • Phone: 612-725-2000
  • Fax:
Mailing address:
  • Phone: 612-725-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberR 105818-7
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: