| NPI | 1699652883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH LEWIS Owner 612-670-4870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202D00000X |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-08-19 |