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General NPI Number Information
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NPI Number | 1467906982
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Entity Type | Individual
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Provider Name | ANNE VAN GAVER AUD
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Gender | Female
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 345 SMITH AVE N
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City | SAINT PAUL
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State | MN
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Zip | 55102-2346
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Country | US
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Telephone | 320-237-6737
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Fax |
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Provider Business Mailing Address
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Address Line | 347 SMITH AVE N STE 600
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City | SAINT PAUL
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State | MN
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Zip | 55102-3362
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Country | US
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Telephone | 320-237-6737
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 3149
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 10122
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License Number State | MN
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