Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 35955 | MN |
NPI | 1033106091 |
---|---|
Provider Name | Nancy J Mendelsohn |
First Address | Roseville, MN 55113-1182 |
Second Address | Saint Paul, MN 55102-2387 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
085068300 | (05) | MN |
F32109 | (02) |