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NPI Code Detail

MEDICARE: GRETCHEN MARYANNE NESS LPN

MEDICARE: GRETCHEN MARYANNE NESS LPN
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
1164W00000XLicensed Practical NurseL 052305-3MN

General Provider Information

NPI Number : 1730312158
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRETCHEN MARYANNE NESS LPN
Provider Business Mailing Address
First Line : 1132 CENTRAL AVE NE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1512
Country : US
Telephone Number : 612-236-1700
Fax Number : 612-236-1701
Provider Business Practice Location Address
First Line : 1132 CENTRAL AVE NE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1512
Country : US
Telephone Number : 612-236-1700
Fax Number : 612-236-1701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2009
Last Update Date : 09/02/2009

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