Provider Demographics
NPI:1184726408
Name:PASNECKER, FRANCIS (PHD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:
Last Name:PASNECKER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 FORD ROAD
Mailing Address - Street 2:UNIT B
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426
Mailing Address - Country:US
Mailing Address - Phone:952-378-1800
Mailing Address - Fax:952-378-1714
Practice Address - Street 1:1155 FORD ROAD
Practice Address - Street 2:UNIT B
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:952-378-1800
Practice Address - Fax:952-378-1714
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2412103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN446352800Medicaid
MNLP2412OtherMN STATE LICENCE
MN680001096Medicare ID - Type Unspecified