Connie Lee Gable, LPN

Individual provider Active NPI Licensed Practical Nurse · Watertown, MN

NPI 1851661763 · NPPES record last updated Jan 9, 2012

Key facts

NPI
1851661763
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L46360-5 (MN)
Practice address
317 Ortloff TRL NW
Watertown, MN 55388-9102
Phone
(952) 237-2834
NPI assigned
Jan 9, 2012
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)
No

State licenses

LicenseStateTypeSpecialty
L46360-5MNMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L46360-5 MN Yes

Addresses

Primary practice location

317 Ortloff TRL NW
Watertown, MN 55388-9102

Mailing address

317 Ortloff TRL NW
Watertown, MN 55388-9102

Other providers in Watertown, MN

All providers in Watertown, MN · Licensed Practical Nurse in Minnesota

Sources for this page

Verify at the official NPI Registry.