Healthcare Provider Details

I. General information

NPI: 1417916461
Provider Name (Legal Business Name): LYNN R ORLOWSKI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 JACKSON ST MAIL STOP 11302C HEALTHPARTNERS REGIONS BEHAVIORAL HEAL
ST. PAUL MN
55112-2502
US

IV. Provider business mailing address

8170 33RD AVE S MS21110Q
MINNEAPOLIS MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-4786
  • Fax: 651-254-9426
Mailing address:
  • Phone: 952-883-5375
  • Fax: 651-254-9426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1335295
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: