Individual
LEE ANN HERTZOG DONOVAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
250 N CENTRAL AVE, #101, WAYZATA, MN 55391
(952) 473-0211
(952) 473-7908
Mailing address
250 N CENTRAL AVE, #101, WAYZATA, MN 55391
(952) 473-0211
(952) 473-7908
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
R1497120
MN
Other
Enumeration date
02/07/2006
Last updated
07/08/2007
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