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1194895888

NPI Code Detail

MEDICARE: PAULA C DEARHOLT RN, WHCNP

MEDICARE: PAULA C DEARHOLT RN, WHCNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	R124952-7	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	122972	OTHER		UCARE PROVIDER ID
2	HP26447	OTHER		HEALTH PARTNERS PROV ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1068173	OTHER		AMERICA'S PPO PROV ID
5	29076	OTHER		SIOUX VALLEY PROV ID
6	1016947	OTHER		PREFERRED ONE PROV ID
7	68G08DE	OTHER		BCBS MN PROVIDER ID
8	07-00637	OTHER		MEDICA PROVIDER ID

General Provider Information

NPI Number	:	1194895888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA C DEARHOLT RN, WHCNP

Provider Business Mailing Address
First Line	:	209 CYPRESS DR
Second Line	:
City	:	MANKATO
State	:	MN
Zip	:	56001-7575
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	671 VANDALIA ST
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1312
Country	:	US
Telephone Number	:	218-368-2798
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	11/19/2024

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Directions to “ PAULA C DEARHOLT RN, WHCNP” Practice Location

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