Basic Information
| Provider Information | |||||||||
| NPI: | 1831162379 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARADISE | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | GAUGHAN | ||||||||
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| Credential: | RN, CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6405 FRANCE AVE S | ||||||||
| Address2: | SUITE W400 | ||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554352163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529202730 | ||||||||
| FaxNumber: | 9525677090 | ||||||||
| Practice Location | |||||||||
| Address1: | 6405 FRANCE AVE S | ||||||||
| Address2: | SUITE W400 | ||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554352163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529202730 | ||||||||
| FaxNumber: | 9525677090 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 02/06/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | R1135178 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.