Individual
BERNADETTE LEE CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
870 GRAND AVE, SAINT PAUL, MN 55105-3291
(651) 326-5650
Mailing address
870 GRAND AVE, SAINT PAUL, MN 55105-3291
(651) 326-5650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36514
MN
Other
Enumeration date
08/31/2006
Last updated
07/19/2012
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