Organization
MINNESOTA NEONATAL SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI BROWN (OFFICE MANAGER)
(612) 322-6905
Entity
Organization
Contact information
Practice address
9875 HOSPITAL DR, MAPLE GROVE, MN 55369-4648
(612) 322-6903
Mailing address
9325 UPLAND LN N STE 360, MAPLE GROVE, MN 55369-4463
(612) 322-6903
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LN0000X
Neonatal Nurse Practitioner
—
—
Other
Enumeration date
04/21/2020
Last updated
08/02/2024
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