Individual
TAYLOR ROSE HAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 883-1000
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12429
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/13/2024
Last updated
02/05/2025
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