| Doctor Name: | MRS. ANGELA VANDERHEYDEN |
| NPI Number: | 1255647798 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NURSE PRACTITIONER |
| License Number: | R1691997 |
| Business Practice Address: | 3850 Park Nicollet Blvd Senior Services Saint Louis Park, MN - 554162527 |
| Business Phone Number: | 9529935041 |
| Business Fax Number: | 9529936406 |
| Mailing Address: | 2243 Gettysburg Ave S, SAINT LOUIS PARK |
| State: | MN |
| Postal Code: | 554262341 |
| Phone Number: | 6127192173 |
| Fax Number: | |
| NPI Enumeration Date: | 08/22/2010 |
| NPI Last Update Date: | 10/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | R1691997 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |