Individual
DR. SUSAN DEBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
15350 ENGLISH AVE, APPLE VALLEY, MN 55124
(952) 431-8500
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11602
MN
363LF0000X
Family Nurse Practitioner
35114
TN
Other
Enumeration date
03/29/2024
Last updated
10/08/2024
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