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NPI Code Detail

MEDICARE: PATRICIA LONGARD

MEDICARE: PATRICIA LONGARD
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
1363L00000XNurse PractitionerR-134741-6MN
2367A00000XAdvanced Practice Midwife132MN

General Provider Information

NPI Number : 1912969247
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA LONGARD
Provider Business Mailing Address
First Line : 153 CESAR CHAVEZ ST
Second Line :
City : SAINT PAUL
State : MN
Zip : 55107-2226
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1026 7TH ST W
Second Line :
City : SAINT PAUL
State : MN
Zip : 55102-3828
Country : US
Telephone Number : 651-758-9500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 12/18/2024

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Directions to “ PATRICIA LONGARD ” Practice Location

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