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General NPI Number Information
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NPI Number | 1861464042
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Entity Type | Individual
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Provider Name | CATHY RESNICK SACKETT WHNP
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Gender | Female
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6845 LEE AVE N MAIL STOP 31400A
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-1717
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Country | US
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Telephone | 763-569-0300
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Fax | 763-569-0311
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Provider Business Mailing Address
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Address Line | 8100 34TH AVE S 21110Q
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1672
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Country | US
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Telephone | 952-883-7961
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Fax | 952-883-5395
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R0993997
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License Number State | MN
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