=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932132826
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELIZABETH ANN NORHEIM RN, CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2006
-----------------------------------------------------
Last Update Date | 08/30/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 CARLSON PKWY MAIL ROUTE CP320
-----------------------------------------------------
City | MINNETONKA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55305-5359
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-992-8000
-----------------------------------------------------
Fax | 952-992-3039
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8940 HIGHVIEW CT
-----------------------------------------------------
City | VICTORIA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55386-4543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-368-4309
-----------------------------------------------------
Fax | 952-368-4934
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | R104133-0
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------