NPI 1205174968 · live from the CMS NPI Registry
Chris Jensen
Skilled Nursing Facility in Duluth, MN. National Provider Identifier 1205174968, active.
NPI record
| NPI | 1205174968 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 2501 Rice Lake Rd, Duluth, MN 55811 |
| Practice phone | 218-625-6444 |
| Enumerated | January 30, 2013 |
| Last updated | January 30, 2013 |
| Authorized official | Natalya Nektalov, Occupational Therapist/L |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | 104229 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.