Provider Demographics
NPI:1508051673
Name:TWITO, DEBORAH MARY (APRN-BC OR MS,RN,CNS)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:MARY
Last Name:TWITO
Suffix:
Gender:F
Credentials:APRN-BC OR MS,RN,CNS
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:M
Other - Last Name:TWITO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN-BC OR MS,RN,CNS
Mailing Address - Street 1:2545 CHICAGO AVE
Mailing Address - Street 2:MEDICAL OFFICE BUILDING, SEVENTH FLOOR, SUITE 701
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4522
Mailing Address - Country:US
Mailing Address - Phone:651-645-7367
Mailing Address - Fax:
Practice Address - Street 1:2545 CHICAGO AVE
Practice Address - Street 2:MEDICAL OFFICE BUILDING, SEVENTH FLOOR, SUITE 701
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4522
Practice Address - Country:US
Practice Address - Phone:612-863-5327
Practice Address - Fax:612-863-2596
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 090551-6163W00000X
MN2007003348-01364SP0809X
MN0318364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult