Healthcare Provider Details

I. General information

NPI: 1457336232
Provider Name (Legal Business Name): PAULETTE M. HEROLD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 01/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 WABASHA ST S HEALTH PARTNERS/ST PAUL CLINIC
SAINT PAUL MN
55107-1805
US

IV. Provider business mailing address

205 WABASHA ST S HEALTH PARTNERS/ST PAUL CLINIC
ST PAUL MN
55107-1805
US

V. Phone/Fax

Practice location:
  • Phone: 651-293-8100
  • Fax: 651-293-8106
Mailing address:
  • Phone: 651-293-8100
  • Fax: 651-293-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberH-043411
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: