Healthcare Provider Details

I. General information

NPI: 1295101178
Provider Name (Legal Business Name): AUTUMN LANI BROWN LOVAS APRN, CNM, LSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 W 106TH ST
BLOOMINGTON MN
55431-4126
US

IV. Provider business mailing address

9100 RILEY LAKE RD
EDEN PRAIRIE MN
55347-3214
US

V. Phone/Fax

Practice location:
  • Phone: 952-681-6518
  • Fax:
Mailing address:
  • Phone: 952-452-6731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM0273
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: