Provider Demographics
NPI:1043070683
Name:SHRESTHA DANGOL, SABINA (CNP)
Entity type:Individual
Prefix:
First Name:SABINA
Middle Name:
Last Name:SHRESTHA DANGOL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SABINA
Other - Middle Name:
Other - Last Name:SHRESTHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1700 UNIVERSITY AVE W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3727
Mailing Address - Country:US
Mailing Address - Phone:320-469-4234
Mailing Address - Fax:
Practice Address - Street 1:2945 HAZELWOOD ST STE 200A
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1243
Practice Address - Country:US
Practice Address - Phone:651-232-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty