Individual
DEANNA PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3400 W 66TH ST STE 150, EDINA, MN 55435-2109
(952) 920-7200
Mailing address
21381 HYTRAIL CIR, LAKEVILLE, MN 55044-6035
(952) 239-4568
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
10144
MN
363LG0600X
Gerontology Nurse Practitioner
10144
MN
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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