Provider Demographics
NPI:1982440350
Name:RONNING, MICHAEL J (FNP-C)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:RONNING
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21583
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55121-0583
Mailing Address - Country:US
Mailing Address - Phone:651-236-9901
Mailing Address - Fax:651-236-9901
Practice Address - Street 1:210 9TH ST SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6400
Practice Address - Country:US
Practice Address - Phone:507-288-3443
Practice Address - Fax:507-292-7007
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12027363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily