Provider Demographics
NPI:1952021487
Name:DEAN, DUSTIN GENE (PMHNP)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:GENE
Last Name:DEAN
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:DUSTIN
Other - Middle Name:GENE
Other - Last Name:BLANKENSHIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 ORCHARDVIEW LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-4326
Mailing Address - Country:US
Mailing Address - Phone:507-379-7660
Mailing Address - Fax:
Practice Address - Street 1:315 ELTON HILLS DR NW STE 201
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2989
Practice Address - Country:US
Practice Address - Phone:507-322-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9482363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty