Healthcare Provider Details

I. General information

NPI: 1154066199
Provider Name (Legal Business Name): ABBEY FRANCES JAWANDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABBEY FRANCES HUSBY MSN, RN

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 VETERANS DR
SAINT CLOUD MN
56303-2015
US

IV. Provider business mailing address

4801 VETERANS DR
SAINT CLOUD MN
56303-2015
US

V. Phone/Fax

Practice location:
  • Phone: 320-252-1670
  • Fax:
Mailing address:
  • Phone: 320-223-2170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberR195483-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: