Provider Demographics
NPI:1629257613
Name:RHEUMATOLOGY NURSE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:RHEUMATOLOGY NURSE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABRUZZESE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CNP
Authorized Official - Phone:952-224-4413
Mailing Address - Street 1:7200 FRANCE AVE S
Mailing Address - Street 2:SUITE 235
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4300
Mailing Address - Country:US
Mailing Address - Phone:952-224-4413
Mailing Address - Fax:
Practice Address - Street 1:7200 FRANCE AVE S
Practice Address - Street 2:SUITE 235
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4300
Practice Address - Country:US
Practice Address - Phone:952-224-4413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC03613OtherMEDICARE GROUP NUMBER