Individual
ANNE LOUISE BOISCLAIR-FAHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
UNIVERSITY OF MINNESOTA PHYSICIANS, 516 DELAWARE STREET SE, PWB FIRST FLOOR, CLINIC 1E, MINNEAPOLIS, MN 55455
(612) 626-6666
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MMC 394, MINNEAPOLIS, MN 55455
(612) 626-6666
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R 083633-9
MN
363LP0200X
Pediatric Nurse Practitioner
R 083633-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014054
PREFERRED ONE
MN
01
—
12-02883
MEDICA PRIMARY
MN
01
—
12-02906
MEDICA CHOICE
MN
01
—
120222
UCARE
MN
01
—
1401466
ARAZ
MN
05
—
4303091
—
MT
01
—
HP19824
HEALTHPARTNERS
MN
Enumeration date
06/22/2006
Last updated
12/12/2007
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