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General NPI Number Information
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NPI Number | 1558486332
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Entity Type | Organization
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Legal Business Name | ABBOTT NORTHWESTERN HOSPITAL
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 5315 HIGHPOINTE DR
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City | BLOOMINGTON
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State | MN
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Zip | 55437-1962
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Country | US
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Telephone | 952-200-6668
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Fax |
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Provider Business Mailing Address
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Address Line | 5315 HIGHPOINTE DRIVE
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City | BLOOMINGTON
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State | MN
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Zip | 55437
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Country | US
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Telephone | 952-200-6668
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Fax |
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Authorized Official
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Title or Position | OTL
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Name | DIANE BROWN
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Credential |
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Telephone | 952-200-6668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 100046
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License Number State | MN
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