Healthcare Provider Details

I. General information

NPI: 1447485321
Provider Name (Legal Business Name): ANGELA SINNER BEGNAUD D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA SINNER D.O.

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 UNIVERSITY AVE E GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
SAINT PAUL MN
55101-2507
US

IV. Provider business mailing address

1123 AUTUMN ST
ROSEVILLE MN
55113-6102
US

V. Phone/Fax

Practice location:
  • Phone: 651-578-5098
  • Fax:
Mailing address:
  • Phone: 651-578-5098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number54266
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: