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NPI Code Detail

MEDICARE: BETH E WODRICH NP

MEDICARE: BETH E WODRICH NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerCNP0984MN
2363LF0000XFamily Nurse Practitioner984MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245241629
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH E WODRICH NP
Provider Business Mailing Address
First Line : 2925 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1321
Country : US
Telephone Number : 612-262-9000
Fax Number :
Provider Business Practice Location Address
First Line : 2800 CHICAGO AVE STE 250
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1355
Country : US
Telephone Number : 612-863-4096
Fax Number : 612-863-2132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 06/03/2025

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Directions to “ BETH E WODRICH NP” Practice Location

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