Individual
MAUREEN ERVIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 222-1816
(651) 602-7517
Mailing address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
079840-6
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107026
MEDICA
MN
01
—
140406
UCARE
MN
01
—
53M26ER
BCBS
MN
01
—
923911028379
PREFERRED ONE
MN
01
—
HP27726
HEALTH PARTNERS
MN
Enumeration date
03/31/2006
Last updated
07/08/2007
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