Provider Demographics
NPI:1427763218
Name:DAHLQUIST, RACHEL ANN (CNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:DAHLQUIST
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 413TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:BRAHAM
Mailing Address - State:MN
Mailing Address - Zip Code:55006-3415
Mailing Address - Country:US
Mailing Address - Phone:320-364-0938
Mailing Address - Fax:
Practice Address - Street 1:301 HIGHWAY 65 S
Practice Address - Street 2:
Practice Address - City:MORA
Practice Address - State:MN
Practice Address - Zip Code:55051-1899
Practice Address - Country:US
Practice Address - Phone:320-679-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9882363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology