Organization
MARCIANA GROUP
Active
Other names
Mendota Health
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY MILLER (DIRECTOR OF RCM)
(248) 331-7908
Entity
Organization
Contact information
Practice address
16759 DIAMONTE PATH, LAKEVILLE, MN 55044-6154
(651) 398-4968
Mailing address
1270 NORTHLAND DR STE 250, MENDOTA HEIGHTS, MN 55120-1189
(888) 402-0202
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
03/24/2026
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