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General NPI Number Information
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NPI Number | 1114112075
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Entity Type | Individual
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Provider Name | APRIL MARIE DORNSBACH P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 4300 EDGEWOOD DR NE
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City | SAINT MICHAEL
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State | MN
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Zip | 55376-4588
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Country | US
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Telephone | 763-744-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone | 612-262-9000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PENDING
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License Number State | MN
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