Individual
BRENDA NOVACINSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2401 FAIRVIEW AVE N # 145, ROSEVILLE, MN 55113-2708
(763) 225-9050
Mailing address
1000 41ST AVE NE #120, COLUMBIA HEIGHTS, MN 55421-4121
(763) 788-0145
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
363L00000X
MN
363LF0000X
Family Nurse Practitioner
CNP1068
MN
363LG0600X
Gerontology Nurse Practitioner
1068
MN
Other
Enumeration date
12/01/2011
Last updated
01/10/2024
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