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NPI Code Detail

MEDICARE: JASMINE LANAE PRICE

MEDICARE: JASMINE LANAE PRICE
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
1163WP0807XChild & Adolescent Psychiatric/Mental Health Registered Nurse2502162MN

General Provider Information

NPI Number : 1467268250
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE LANAE PRICE
Provider Business Mailing Address
First Line : 1660 107TH AVE NW
Second Line :
City : COON RAPIDS
State : MN
Zip : 55433-4285
Country : US
Telephone Number : 651-309-7731
Fax Number :
Provider Business Practice Location Address
First Line : 5500 94TH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55443-1992
Country : US
Telephone Number : 763-762-2838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2024
Last Update Date : 12/05/2024

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Directions to “ JASMINE LANAE PRICE ” Practice Location

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