Organization
UNIVERSITY OF MINNESOTA PHYSICIANS
Active
Other names
University of Minnesota Health Nurse Practitioners-A UMPhysicians Clin
Organization subpart
No
Provider details
NPI number
Authorized official
MARY A JOHNSON COO (CHIEF OPERATING OFFICER)
(612) 884-0802
Entity
Organization
Contact information
Practice address
814 SOUTH 3RD ST, MINNEAPOLIS, MN 55415
(612) 888-9792
(612) 888-9762
Mailing address
6300 SHINGLE CREEK PARKWAY, SUITE 600, BROOKLYN CENTER, MN 55430-2127
(763) 782-6400
(763) 782-9558
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02390
MEDICARE PTAN
MN
Enumeration date
12/04/2014
Last updated
12/04/2014
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