Mauder, Michelle

Mauder, Michelle is an individual health care provider with primary practice located at 360 Colborne St , Saint Paul MN 55102-3228. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Mauder, Michelle can be contacted via phone (651) 767-8189.

Contact Information

Primary practice address
360 Colborne St Saint Paul MN 55102-3228
Phone: (651) 767-8189
Fax: (651) 228-3649
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R143864-2 Minnesota

Profile Details

NPI number 1104870906
LBN Legal business name Mauder, Michelle
Credentials RN,CNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Oct 13th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104870906 NPPES
Minnesota MEDICAID 246910300

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