Willer Sly, Dianne J

Willer Sly, Dianne J is an individual health care provider with primary practice located at 8170 33Rd Ave S Mc21110Q, Bloomington MN 55425-4516. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Willer Sly, Dianne J can be contacted via phone (952) 883-6805.

Contact Information

Primary practice address
8170 33Rd Ave S Mc21110Q Bloomington MN 55425-4516
Phone: (952) 883-6805
Fax: (952) 883-6117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1052099 Minnesota

Profile Details

NPI number 1639143019
LBN Legal business name Willer Sly, Dianne J
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Nov 17th, 2008 - about 16 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 1639143019 NPPES
Minnesota MEDICAID 889697600

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