Provider Demographics
NPI:1891752366
Name:GARCIA, JOSEPHINE DC (APRN BC FNPC)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:DC
Last Name:GARCIA
Suffix:
Gender:F
Credentials:APRN BC FNPC
Other - Prefix:MRS
Other - First Name:JOSEPHINE
Other - Middle Name:DC
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:816 HIDDEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-5457
Mailing Address - Country:US
Mailing Address - Phone:612-225-1538
Mailing Address - Fax:
Practice Address - Street 1:920 2ND AVE S
Practice Address - Street 2:SUITE 400
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-3318
Practice Address - Country:US
Practice Address - Phone:612-225-1538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX609276363LF0000X
MNR188017-7363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163827201Medicaid
8N4070OtherBCBS
8N4070OtherBCBS
TX163827201Medicaid