Provider Demographics
NPI:1588700702
Name:ZINKEN, DEBRA C (MA, RN, CNP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:C
Last Name:ZINKEN
Suffix:
Gender:F
Credentials:MA, RN, CNP
Other - Prefix:MISS
Other - First Name:DEBRA
Other - Middle Name:C
Other - Last Name:CHRISTIANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21370 JOHN MILLESS DR
Mailing Address - Street 2:SUITE #210
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-9449
Mailing Address - Country:US
Mailing Address - Phone:763-428-2288
Mailing Address - Fax:763-428-2132
Practice Address - Street 1:21370 JOHN MILLESS DR
Practice Address - Street 2:SUITE #210
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-9449
Practice Address - Country:US
Practice Address - Phone:763-428-2288
Practice Address - Fax:763-428-2132
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR101756-8363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health