Provider Demographics
NPI:1699035360
Name:ORTMAN, SYNDAL (RN, DNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SYNDAL
Middle Name:
Last Name:ORTMAN
Suffix:
Gender:F
Credentials:RN, DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PARK AVE # MC-G2
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-2765
Mailing Address - Fax:
Practice Address - Street 1:900 S 8TH ST
Practice Address - Street 2:B1. 310
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-1292
Practice Address - Country:US
Practice Address - Phone:612-873-6369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR180584-8163W00000X
MN2012013879363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse