Provider Demographics
NPI:1801616248
Name:ROXANNE J DOBRAVA
Entity type:Organization
Organization Name:ROXANNE J DOBRAVA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:DOBRAVA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:612-429-7338
Mailing Address - Street 1:154 E BROADWAY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-8944
Mailing Address - Country:US
Mailing Address - Phone:612-429-8280
Mailing Address - Fax:855-239-8566
Practice Address - Street 1:154 E BROADWAY ST STE 2
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-8944
Practice Address - Country:US
Practice Address - Phone:612-429-8280
Practice Address - Fax:855-239-8566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty