Provider Demographics
NPI:1134183528
Name:HERRMANN, DENISE ANN (RN CNP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:ANN
Last Name:HERRMANN
Suffix:
Gender:F
Credentials:RN CNP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:ANN
Other - Last Name:ORNELAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN CNP
Mailing Address - Street 1:360 COLBORNE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3228
Mailing Address - Country:US
Mailing Address - Phone:651-767-8380
Mailing Address - Fax:651-228-3649
Practice Address - Street 1:360 COLBORNE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3228
Practice Address - Country:US
Practice Address - Phone:651-767-8380
Practice Address - Fax:651-228-3649
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-095797-5363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics