Provider Demographics
NPI:1861564528
Name:OHNESORGE, ELIZABETH POWERS (OPTICIAN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:POWERS
Last Name:OHNESORGE
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 MARQUETTE AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2417
Mailing Address - Country:US
Mailing Address - Phone:612-333-2852
Mailing Address - Fax:612-333-1953
Practice Address - Street 1:1006 MARQUETTE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2417
Practice Address - Country:US
Practice Address - Phone:612-333-2852
Practice Address - Fax:612-333-1953
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4342OtherDAVIS VISION
MN2121692OtherMEDICA
MN02484OtherSPECTERA
MN102100OtherUCARE