Provider Demographics
NPI:1578599460
Name:DRECHNIK, ROSALIE CAROL (CPNP)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:CAROL
Last Name:DRECHNIK
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:ROSALIE
Other - Middle Name:CAROL
Other - Last Name:DAUFFENBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:606-24TH ST STE 502
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454
Mailing Address - Country:US
Mailing Address - Phone:612-626-3444
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:606-24TH ST STE 502
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:612-626-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR070223-0363L00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
07-08110OtherMEDICA PRIMARY
1016336OtherPREFERRED ONE
114958OtherUCARE
07-08110OtherMEDICA CHOICE
15G83DROtherBCBS
607396OtherARAZ PPO