Provider Demographics
NPI:1043070683
Name:SHRESTHA DANGOL, SABINA
Entity Type:Individual
Prefix:
First Name:SABINA
Middle Name:
Last Name:SHRESTHA DANGOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SABINA
Other - Middle Name:
Other - Last Name:SHRESTHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:206 ULMER DR
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-1228
Mailing Address - Country:US
Mailing Address - Phone:320-469-4234
Mailing Address - Fax:
Practice Address - Street 1:500 HARVARD ST SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0363
Practice Address - Country:US
Practice Address - Phone:612-273-6909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNF02240770363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty