Provider Demographics
NPI:1457746281
Name:FON, FLORENCE (FNP)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:
Last Name:FON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COUNTY ROAD B E STE 3
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-1945
Mailing Address - Country:US
Mailing Address - Phone:651-207-8372
Mailing Address - Fax:651-756-8527
Practice Address - Street 1:5 COUNTY ROAD B E STE 3
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-1945
Practice Address - Country:US
Practice Address - Phone:651-207-8372
Practice Address - Fax:651-756-8527
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2014035499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily