# MODERN THERAPEUTICS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Modern Therapeutics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356159891
- **Authorized official:** ANDREA BERUBE CRNA (OWNER)
- **Authorized official phone:** (612) 616-7731

## Contact information

- **Practice address:** 502 DIVISION ST S, NORTHFIELD, MN 55057-2020
- **Practice address phone:** (612) 488-2248
- **Practice address fax:** (612) 488-2248
- **Mailing address:** 502 DIVISION ST S, NORTHFIELD, MN 55057-2020
- **Mailing address phone:** (612) 488-2248
- **Mailing address fax:** (612) 488-2248

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/30/2024
- **Last updated:** 08/17/2026