Organization
TARGET CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY BERRYHILL (FNP)
(612) 327-5134
Entity
Organization
Contact information
Practice address
1300 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4103
(651) 642-1146
Mailing address
1300 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4103
(651) 642-1146
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R 158470 3
MN
Other
Enumeration date
12/24/2014
Last updated
12/24/2014
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