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General NPI Number Information
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NPI Number | 1790880359
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Entity Type | Individual
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Provider Name | CHARLOTTE KATHERINE DEPEW RN, CNP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1200 18TH ST E
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City | HASTINGS
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State | MN
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Zip | 55033-3680
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Country | US
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Telephone | 651-438-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 5201 JAMES AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55419-1136
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Country | US
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Telephone | 612-925-3063
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R0601357
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License Number State | MN
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