Healthcare Provider Details

I. General information

NPI: 1134892771
Provider Name (Legal Business Name): MINJI NA RANSOM FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 1ST ST SE
WAUKON IA
52172-2022
US

IV. Provider business mailing address

2708 BRIDGE AVE
ALBERT LEA MN
56007-2077
US

V. Phone/Fax

Practice location:
  • Phone: 563-568-3411
  • Fax:
Mailing address:
  • Phone: 507-377-6285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8306
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA164273
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: