Provider Demographics
NPI:1508642737
Name:STROM, PARIS (CNP)
Entity Type:Individual
Prefix:
First Name:PARIS
Middle Name:
Last Name:STROM
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:PARIS
Other - Middle Name:
Other - Last Name:DUNLOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:999 SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-1125
Mailing Address - Country:US
Mailing Address - Phone:651-270-4833
Mailing Address - Fax:
Practice Address - Street 1:3433 BROADWAY ST NE STE 300
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-1761
Practice Address - Country:US
Practice Address - Phone:612-260-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10716363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology