MEDICARE: ANN MARESH 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
1	363L00000X	Nurse Practitioner	RN1004678	DC

General Provider Information

NPI Number	:	1457304206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN MARESH NP

Provider Business Mailing Address
First Line	:	720 WASHINGTON AVE SE
Second Line	:	SUITE 200
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-2924
Country	:	US
Telephone Number	:	612-884-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 WASHINGTON AVE SE
Second Line	:	SUITE 200
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-2924
Country	:	US
Telephone Number	:	612-884-0600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	07/08/2007

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