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NPI Code Detail

MEDICARE: PAULETTE M. HEROLD ARNP

MEDICARE: PAULETTE M. HEROLD ARNP
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
1363LX0106XOccupational Health Nurse PractitionerH-043411IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R 198673-8OTHERMNMN NURSING LICENSE

General Provider Information

NPI Number : 1457336232
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULETTE M. HEROLD ARNP
Provider Business Mailing Address
First Line : 205 WABASHA ST S
Second Line : HEALTH PARTNERS/ST PAUL CLINIC
City : ST PAUL
State : MN
Zip : 55107-1805
Country : US
Telephone Number : 651-293-8100
Fax Number : 651-293-8106
Provider Business Practice Location Address
First Line : 205 WABASHA ST S
Second Line : HEALTH PARTNERS/ST PAUL CLINIC
City : SAINT PAUL
State : MN
Zip : 55107-1805
Country : US
Telephone Number : 651-293-8100
Fax Number : 651-293-8106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 01/11/2013

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