Wiborg, Elizabeth A

Wiborg, Elizabeth A is an individual health care provider with primary practice located at 2450 26Th Ave S , Minneapolis MN 55406-1245. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Wiborg, Elizabeth A can be contacted via phone (612) 721-2491.

Contact Information

Primary practice address
2450 26Th Ave S Minneapolis MN 55406-1245
Phone: (612) 721-2491
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X R 94784-6 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X CNP 2753 Minnesota

Profile Details

NPI number 1154380871
LBN Legal business name Wiborg, Elizabeth A
Credentials RN CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Jan 8th, 2020 - about 5 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 1154380871 NPPES
Minnesota MEDICAID 504536600

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