MEDICARE: JAIMIE ANN BERAN

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	1041S0200X	School Social Worker	27022	MN

General Provider Information

NPI Number	:	1588507032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIMIE ANN BERAN

Provider Business Mailing Address
First Line	:	6100 MOORE LAKE DR W
Second Line	:
City	:	FRIDLEY
State	:	MN
Zip	:	55432-5602
Country	:	US
Telephone Number	:	763-502-5575
Fax Number	:

Provider Business Practice Location Address
First Line	:	6100 MOORE LAKE DR W
Second Line	:
City	:	FRIDLEY
State	:	MN
Zip	:	55432-5602
Country	:	US
Telephone Number	:	763-502-5575
Fax Number	:

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ JAIMIE ANN BERAN ” Practice Location

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