Provider Demographics
NPI:1568564961
Name:DUCOMMUN, JOANNE MARGUERITE (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MARGUERITE
Last Name:DUCOMMUN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MS
Other - First Name:JOANNE
Other - Middle Name:MARGUERITE
Other - Last Name:TOLLEFSRUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:13105 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-3854
Mailing Address - Country:US
Mailing Address - Phone:952-894-6633
Mailing Address - Fax:
Practice Address - Street 1:225 SMITH AVE N
Practice Address - Street 2:ST. PAUL HEART CLINIC,SUITE 400
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2534
Practice Address - Country:US
Practice Address - Phone:651-292-0616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR085971-4163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice