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NPI Code Detail

MEDICARE: NORMA J CHEESEBROW WHNP

MEDICARE: NORMA J CHEESEBROW WHNP
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 Practitioner0759403MN

General Provider Information

NPI Number : 1912978362
Entity Type Code : Individual
Provider Name (Legal Business Name) : NORMA J CHEESEBROW WHNP
Provider Business Mailing Address
First Line : 8100 34TH AVE S
Second Line : MC21110Q
City : BLOOMINGTON
State : MN
Zip : 55425-1672
Country : US
Telephone Number : 952-883-7172
Fax Number : 952-883-5395
Provider Business Practice Location Address
First Line : 3930 NORTHWOODS DR
Second Line : MAIL STOP 32800A
City : ARDEN HILLS
State : MN
Zip : 55112-6974
Country : US
Telephone Number : 651-490-6700
Fax Number : 651-490-6730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 07/08/2007

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