Provider Demographics
NPI:1093700841
Name:POPE COUNTY PUBLIC HEALTH NURSING SERVICE
Entity Type:Organization
Organization Name:POPE COUNTY PUBLIC HEALTH NURSING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAATEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN PHN
Authorized Official - Phone:320-634-5720
Mailing Address - Street 1:211 MINNESOTA AVE E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:56334-1629
Mailing Address - Country:US
Mailing Address - Phone:320-634-5720
Mailing Address - Fax:320-634-0159
Practice Address - Street 1:211 MINNESOTA AVE E
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENWOOD
Practice Address - State:MN
Practice Address - Zip Code:56334-1629
Practice Address - Country:US
Practice Address - Phone:320-634-5720
Practice Address - Fax:320-634-0159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
8270POOtherBCBS
829421017248OtherPREFERRED ONE
83000089OtherMEDICA
126381OtherU CARE
8G547POOtherBCBS
03072603600OtherPRIMEWEST
247100AAMedicare ID - Type Unspecified