Individual
ELLEN WITKOWSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNS
Contact information
Practice address
3100 W LAKE ST, SUITE 210, MINNEAPOLIS, MN 55416-4527
(612) 925-6033
(612) 925-8496
Mailing address
3100 W LAKE ST, SUITE 210, MINNEAPOLIS, MN 55416-4527
(612) 925-6033
(612) 925-8496
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
R0786405
MN
364S00000X
Clinical Nurse Specialist
Primary
023561302
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160007C154
UCARE
MN
01
—
411425197
CIGNA BEHAVIORAL HEALTH
MN
05
—
623724000
—
MN
01
—
6260191
MEDICA CHOICE
MN
01
—
98D39WI
BCBS
MN
01
—
HP23318
HEALTHPARTNERS
MN
Enumeration date
12/01/2006
Last updated
12/18/2013
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