Individual
REBECCA G MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN/CNP
Contact information
Practice address
1576 MINNEHAHA AVE W, SAINT PAUL, MN 55104-1208
(651) 698-0891
(651) 644-2609
Mailing address
1576 MINNEHAHA AVE W, SAINT PAUL, MN 55104-1208
(651) 698-0891
(651) 644-2609
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0934105
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213525600
—
MN
Enumeration date
04/05/2006
Last updated
04/20/2020
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