Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | R1153448 | MN |
NPI | 1124085915 |
---|---|
Provider Name | Patricia V Cabrera |
First Address | Bloomington, MN 55425-4516 |
Second Address | Saint Paul, MN 55101-2502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 28/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
045281500 | (05) | MN |