Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | R068159-7 | MN |
NPI | 1164490868 |
---|---|
Provider Name | Catherine M Oman |
First Address | East Bethel, MN 55092-9592 |
Second Address | Maplewood, MN 55109-1163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 08/07/2007 |