NPI 1194139261 · live from the CMS NPI Registry
Community Nurse
Skilled Nursing Facility, Nursing Care, Pediatric in Elk River, MN. National Provider Identifier 1194139261, active.
NPI record
| NPI | 1194139261 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility, Nursing Care, Pediatric 3140N1450X |
| Practice location | 18072 Vance Circle, Elk River, MN 55330 |
| Practice phone | 612-387-6629 |
| Mailing address | 18072 Vance Cir Nw, Elk River, MN 55330 |
| Enumerated | June 17, 2014 |
| Last updated | June 17, 2014 |
| Authorized official | Perkaloah Queeglay-Tarpeh, Registered Nurse |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility, Nursing Care, Pediatric primary | 3140N1450X | — (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.