Individual
PAULA C DEARHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, WHCNP
Contact information
Practice address
671 VANDALIA ST, SAINT PAUL, MN 55114-1312
(218) 368-2798
Mailing address
209 CYPRESS DR, MANKATO, MN 56001-7575
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R124952-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-00637
MEDICA PROVIDER ID
—
01
—
1016947
PREFERRED ONE PROV ID
—
01
—
1068173
AMERICA'S PPO PROV ID
—
01
—
122972
UCARE PROVIDER ID
—
01
—
29076
SIOUX VALLEY PROV ID
—
05
—
666420200
—
MN
01
—
68G08DE
BCBS MN PROVIDER ID
—
01
—
HP26447
HEALTH PARTNERS PROV ID
—
Enumeration date
11/09/2006
Last updated
11/19/2024
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