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NPI Code Detail

MEDICARE: AIM PSYCHIATRIC MENTAL HEALTH SERVICES, LLC

MEDICARE: AIM PSYCHIATRIC MENTAL HEALTH SERVICES, LLC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1801630546
Entity Type Code : Organization
Provider Name (Legal Business Name) : AIM PSYCHIATRIC MENTAL HEALTH SERVICES, LLC
Provider Business Mailing Address
First Line : 8400 NORMANDALE LAKE BLVD., SUITE 920-#93
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55437
Country : US
Telephone Number : 651-299-6187
Fax Number : 651-666-1619
Provider Business Practice Location Address
First Line : 8400 NORMANDALE LAKE BLVD STE 920
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55437-3843
Country : US
Telephone Number : 651-299-6187
Fax Number : 651-666-1619
Authorized Official
Title or Position : OWNER
Name : MICHELLE TREVINO
Credential : PMHNP-BC
Telephone Number : 651-299-6187
Provider Enumeration Date : 06/19/2024
Last Update Date : 06/19/2024

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Directions to “AIM PSYCHIATRIC MENTAL HEALTH SERVICES, LLC ” Practice Location

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