Provider Demographics
NPI:1932132826
Name:NORHEIM, ELIZABETH ANN (RN, CNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:NORHEIM
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8940 HIGHVIEW CT
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:MN
Mailing Address - Zip Code:55386-4543
Mailing Address - Country:US
Mailing Address - Phone:952-368-4309
Mailing Address - Fax:952-368-4934
Practice Address - Street 1:401 CARLSON PKWY
Practice Address - Street 2:MAIL ROUTE CP320
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5359
Practice Address - Country:US
Practice Address - Phone:952-992-8000
Practice Address - Fax:952-992-3039
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR104133-0363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0237035-00Medicaid
MN500002939Medicare ID - Type Unspecified
MNP70939Medicare UPIN