Organization
DERM ON DEMAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RISA ANN ASMUS DORWEILER ANP (OWNER/PROVIDER)
(763) 350-6810
Entity
Organization
Contact information
Practice address
7940 MAIN ST N, MAPLE GROVE, MN 55369-7169
(763) 350-6810
Mailing address
7940 MAIN ST N, MAPLE GROVE, MN 55369-7169
(763) 350-6810
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R1232822
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187282600
—
MN
Enumeration date
04/23/2013
Last updated
06/03/2013
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