Provider Demographics
NPI:1194344234
Name:PESCH, ELISE MARY (DNP)
Entity type:Individual
Prefix:DR
First Name:ELISE
Middle Name:MARY
Last Name:PESCH
Suffix:
Gender:F
Credentials:DNP
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Mailing Address - Street 1:6545 FRANCE AVE S STE 490
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2123
Mailing Address - Country:US
Mailing Address - Phone:952-922-7600
Mailing Address - Fax:952-345-4448
Practice Address - Street 1:6545 FRANCE AVE S STE 490
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2123
Practice Address - Country:US
Practice Address - Phone:952-922-7600
Practice Address - Fax:952-345-4448
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2022-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL041410487163W00000X
MN7514363LF0000X
MN2481244163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse