Individual
REBECCA PROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9325 UPLAND LN N STE 360, MAPLE GROVE, MN 55369-4463
(612) 322-6905
Mailing address
15560 76TH CT NE, OTSEGO, MN 55330-3005
(773) 306-6840
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
5873
CO
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
9971
MN
Other
Enumeration date
12/17/2008
Last updated
01/23/2024
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