Organization
MINNESOTA VITALITY AND ANTI-AGING CENTER
Active
Organization
MINNESOTA VITALITY AND ANTI-AGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER MANSHIP (CO-FOUNDER)
(651) 245-2454
Entity
Organization
Contact information
Practice address
520 HIGHWAY 96 W STE 200, SHOREVIEW, MN 55126-1963
(651) 374-4014
(651) 374-4019
Mailing address
520 HIGHWAY 96 W STE 200, SHOREVIEW, MN 55126-1963
(651) 374-4014
(651) 374-4019
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
05/25/2021
Last updated
06/24/2025
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