Individual
PELAGIE TARA SUFFRINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
210 9TH ST SE, ROCHESTER, MN 55904-6756
(507) 288-3443
Mailing address
210 9TH ST SE, ROCHESTER, MN 55904-6756
(507) 288-3443
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
3035
MN
363LW0102X
Women's Health Nurse Practitioner
CP000487
SD
363LW0102X
Women's Health Nurse Practitioner
R1382989
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP000487
CNP LICENSE
SD
01
—
R035692
RN LICENSE
SD
Enumeration date
12/04/2006
Last updated
02/20/2019
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