Provider Demographics
NPI:1518944230
Name:SCHULZETENBERG, DEBRA L (APRN, CNP)
Entity Type:Individual
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First Name:DEBRA
Middle Name:L
Last Name:SCHULZETENBERG
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Gender:F
Credentials:APRN, CNP
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:PO BOX 1309 MAIL STOP 21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-993-7169
Mailing Address - Fax:952-993-0300
Practice Address - Street 1:2001 BLAISDELL AVE
Practice Address - Street 2:PARK NICOLLET CLINIC - MINNEAPOLIS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404
Practice Address - Country:US
Practice Address - Phone:952-993-8000
Practice Address - Fax:952-993-8039
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2016-03-04
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Provider Licenses
StateLicense IDTaxonomies
MNR111719-6163WP0200X
MNCNP 0757363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics