Provider Demographics
NPI:1396996690
Name:BROGDEN, DEBORAH ILEEN (RN, MSN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ILEEN
Last Name:BROGDEN
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2586 7TH AVE E STE 302
Mailing Address - Street 2:
Mailing Address - City:NORTH ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-3090
Mailing Address - Country:US
Mailing Address - Phone:651-633-7300
Mailing Address - Fax:
Practice Address - Street 1:2586 7TH AVE E STE 302
Practice Address - Street 2:
Practice Address - City:NORTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-3090
Practice Address - Country:US
Practice Address - Phone:651-633-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-05
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 132764-3163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse