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Organization
DESMOINES VALLEY BHS
Active
Organization
DESMOINES VALLEY BHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA HANDEVIDT CNS (OWNER)
(507) 841-0916
Entity
Organization
Contact information
Practice address
803 4TH ST, JACKSON, MN 56143-1056
(507) 841-0916
(507) 847-5664
Mailing address
PO BOX 155, JACKSON, MN 56143-0155
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R0902409
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
374M1DE
BC/BS OF MINNESOTA
MN
01
—
45718
SOUIX VALLEY
MN
Enumeration date
05/22/2007
Last updated
01/02/2008
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