Provider Demographics
NPI:1407072689
Name:POLITZ, JUSTINE FAYE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:FAYE
Last Name:POLITZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9377 GLENBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:MN
Mailing Address - Zip Code:55020-9722
Mailing Address - Country:US
Mailing Address - Phone:952-461-4162
Mailing Address - Fax:
Practice Address - Street 1:NORTHFIELD HOPITAL
Practice Address - Street 2:2000 N. AVE.
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057
Practice Address - Country:US
Practice Address - Phone:507-646-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN089660-9363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health