is a Pediatrics in Minneapolis, Minnesota. practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for is 1588821573. The last update date is .
's current location address is 2450 Riverside Ave Fl 9, Minneapolis, Minnesota. You can contact this provider via phone number 6512080084. The mailing address for is 2450 Riverside Ave Fl 9, Minneapolis, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 2450 Riverside Ave Fl 9, Minneapolis, Minnesota |
| Phone Number | 6512080084 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1588821573 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 2450 Riverside Ave Fl 9 |
|---|---|
| City | Minneapolis |
| State | Minnesota (MN) |
| Post Code | 554541450 |
| Phone Number | 6512080084 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 363Lp0200X |
| Licence No | 2280 |
|
Definition: An advanced practice registered nurse expert in providing care to infants, children and adolescents. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| R160733-4 | MN | MINNESOTA BOARD OF NURSING |
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