Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | R1324646 | MN |
NPI | 1053384511 |
---|---|
Provider Name | Suzanne Gayle Weinberger |
First Address | Edina, MN 55435-2163 |
Second Address | Edina, MN 55435-2163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 06/02/2008 |