Organization
CATHOLIC CHARITIES OF THE ARCHDIOCESE OF ST PAUL AND MPLS
Active
Other names
St Josephs Community Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA O'REILLY (BILLING MGR)
(612) 204-8387
Entity
Organization
Contact information
Practice address
1121 E 46TH ST, MINNEAPOLIS, MN 55407-3562
(612) 204-8387
Mailing address
1200 2ND AVE S, MINNEAPOLIS, MN 55403-2513
(612) 204-8387
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
699726100
—
MN
Enumeration date
10/17/2006
Last updated
01/25/2016
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