Healthcare Provider Details

I. General information

NPI: 1053679381
Provider Name (Legal Business Name): LOIS FOEHRINGER RN PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2356 UNIVERSITY AVE W SUITE 210
SAINT PAUL MN
55114-1853
US

IV. Provider business mailing address

2356 UNIVERSITY AVE W SUITE 210
SAINT PAUL MN
55114-1853
US

V. Phone/Fax

Practice location:
  • Phone: 651-556-9329
  • Fax: 651-556-0880
Mailing address:
  • Phone: 651-556-9329
  • Fax: 651-556-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR083632-6
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: