=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982440350
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL J RONNING FNP-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2024
-----------------------------------------------------
Last Update Date | 10/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 210 N OAK AVE STE 100
-----------------------------------------------------
City | OWATONNA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55060-2369
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-935-5601
-----------------------------------------------------
Fax | 507-292-7354
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 210 9TH ST SE STE 1
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55904-6400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-288-3443
-----------------------------------------------------
Fax | 507-529-6622
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 12027
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------