Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 39316 | MN |
Y | 2084N0402X | Child Neurologist | 39316 | MN |
NPI | 1255589321 |
---|---|
Provider Name | Desiree Kay Czapansky-Beilman |
First Address | Saint Paul, MN 55101-2507 |
Second Address | Saint Paul, MN 55101-2507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2008 |
Last Update Date | 03/09/2008 |