Healthcare Provider Details

I. General information

NPI: 1861001059
Provider Name (Legal Business Name): ANGELSISTERS HOME HEALTHCARE SERVIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2020
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 BUTTERNUT CIR N
BROOKLYN PARK MN
55443-1864
US

IV. Provider business mailing address

10001 BUTTERNUT CIR N
BROOKLYN PARK MN
55443-1864
US

V. Phone/Fax

Practice location:
  • Phone: 612-578-6262
  • Fax:
Mailing address:
  • Phone: 612-578-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: QUEEN GBOR HILL
Title or Position: CO-OWNER/MANAGER
Credential: NP
Phone: 612-578-6292