Organization
INTEGRATIVE GERIATRICS, PLLC
Active
Organization
INTEGRATIVE GERIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA AHLSTROM APRN, CNP (NURSE PRACITIONER/OWNER)
(612) 308-2162
Entity
Organization
Contact information
Practice address
21897 S DIAMOND LAKE RD STE 400-403, ROGERS, MN 55374-4642
(763) 317-1122
Mailing address
21897 S DIAMOND LAKE RD STE 400-403, ROGERS, MN 55374-4642
(763) 317-1122
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/03/2017
Last updated
08/31/2021
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