MEDICARE: PHOENIX NEST INC.

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1639581333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX NEST INC.

Provider Business Mailing Address
First Line	:	2433 5TH AVE S APT 304
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-3643
Country	:	US
Telephone Number	:	612-978-3940
Fax Number	:

Provider Business Practice Location Address
First Line	:	2433 5TH AVE S APT 304
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-3643
Country	:	US
Telephone Number	:	612-978-3940
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. FASCIL BIRHANU DUBALE
Credential	:	B.A
Telephone Number	:	612-978-3940

Provider Enumeration Date	:	05/29/2014
Last Update Date	:	05/29/2014

Similar Medicare Providers

1386588069 — DENEEN JOSEPH
Practice Location Address:

PO BOX 3643
MINNEAPOLIS, MN
55403-0643

Practice Phone: 612-490-1052
Practice Fax:

1891550323 — BRIA MELIN FLORELL CAB-CD, LCCE
Practice Location Address:

914 QUEEN AVE N
MINNEAPOLIS, MN
55411-3643

Practice Phone: 612-226-5269
Practice Fax:

1912840901 — CHRISTOPHER ALAN OLSEN
Practice Location Address:

100 W FRANKLIN AVE STE 205
MINNEAPOLIS, MN
55404-2433

Practice Phone: 651-336-8172
Practice Fax:

1639821671 — MISS JASMYN ANITA CHARMICE SPICER MSW, LICSW
Practice Location Address:

1800 CHICAGO AVE STE 100
MINNEAPOLIS, MN
55404-2592

Practice Phone: 612-879-3115
Practice Fax:

1386838951 — DR. BENJAMIN MUELLER M.D., PH.D.
Practice Location Address:

913 E 26TH ST STE 600
MINNEAPOLIS, MN
55404-4515

Practice Phone: 612-775-6200
Practice Fax: 612-775-6222

1902198740 — DR. SCOTT MONROE BOEKE DO
Practice Location Address:

715 S 8TH ST
MINNEAPOLIS, MN
55404-7530

Practice Phone: 612-873-6963
Practice Fax:

Directions to “PHOENIX NEST INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.