Organization
IVORA HEALTH MINNESOTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLYNN ANNIS APRN (PRESIDENT)
(612) 910-1070
Entity
Organization
Contact information
Practice address
703 WILLOUGHBY WAY W, HOPKINS, MN 55305-5344
(954) 702-3372
Mailing address
703 WILLOUGHBY WAY W, HOPKINS, MN 55305-5344
(954) 702-3372
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/17/2021
Last updated
01/17/2021
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