Basic Information
| Provider Information | |||||||||
| NPI: | 1508051673 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TWITO | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | MARY | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN-BC OR MS,RN,CNS | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | TWITO | ||||||||
| OtherFirstName: | DEBORAH | ||||||||
| OtherMiddleName: | M. | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | APRN-BC OR MS,RN,CNS | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2545 CHICAGO AVE | ||||||||
| Address2: | MEDICAL OFFICE BUILDING, SEVENTH FLOOR, SUITE 701 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554044522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6516457367 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2545 CHICAGO AVE | ||||||||
| Address2: | MEDICAL OFFICE BUILDING, SEVENTH FLOOR, SUITE 701 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554044522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6128635327 | ||||||||
| FaxNumber: | 6128632596 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2007 | ||||||||
| LastUpdateDate: | 05/03/2018 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | R 090551-6 | MN | N | Nursing Service Providers | Registered Nurse | 364SP0809X | 2007003348-01 | MN | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health, Adult | 364S00000X | 0318 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
No ID Information.