Provider Demographics
NPI:1194167643
Name:PHILIPP, MURIEL DENISE (CNP, MA, RN)
Entity type:Individual
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First Name:MURIEL
Middle Name:DENISE
Last Name:PHILIPP
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Gender:F
Credentials:CNP, MA, RN
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Mailing Address - Street 1:1155 FORD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1099
Mailing Address - Country:US
Mailing Address - Phone:952-378-1800
Mailing Address - Fax:952-378-1714
Practice Address - Street 1:1155 FORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-1099
Practice Address - Country:US
Practice Address - Phone:952-378-1800
Practice Address - Fax:952-378-1714
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2015-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNR091756-2363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health