Carrie Schwegman-Norum, RPT

Individual provider Active NPI Physical Therapist · Bagley, MN

NPI 1104907799 · NPPES record last updated Mar 26, 2015

Key facts

NPI
1104907799
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
6242 (MN)
Practice address
1656 Central St W
Bagley, MN 56621-4357
Phone
(218) 694-6640
Fax
(218) 694-6380
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6242MNMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6242 MN Yes

Addresses

Primary practice location

1656 Central St W
Bagley, MN 56621-4357

Mailing address

408 Lomond Loop
Bagley, MN 56621-8153

Other identifiers

IdentifierTypeStateIssuer
6403732OtherMNMEDICA
P00852247OtherMNRR MEDICARE
1104907799MedicaidMN
616055700MedicaidMN
OS1L7SCOtherMNBCBS

Other providers in Bagley, MN

All providers in Bagley, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.