Individual
DR. CONNIE LYNN MANSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
516 DELAWARE STREET SE, PWB, CLINIC 2A UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-6100
Mailing address
420 DELAWARE ST SE, MMC 736 UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30481
MN
207RN0300X
Nephrology Physician
Primary
30481
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055289
—
MT
05
—
0501452
—
IA
01
—
1009229
PREFERREDONE
—
01
—
101482
UCARE
—
05
—
10387
—
ND
01
—
2T161MA
BLUE CROSS BLUE SHIELD
MN
01
—
31-00005
MEDICA - PRIMARY
—
01
—
31-24693
MEDICA - CHOICE
—
05
—
31620100
—
WI
05
—
368285400
—
MN
01
—
768245
ARAZ
—
05
—
7777470
—
SD
01
—
HP22165
HEALTHPARTNERS
—
Enumeration date
08/19/2006
Last updated
02/15/2013
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