Healthcare Provider Details

I. General information

NPI: 1790633030
Provider Name (Legal Business Name): MILKAH BARAKA TERER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 JAMES PL
BURNSVILLE MN
55337-4436
US

IV. Provider business mailing address

1700 JAMES PL
BURNSVILLE MN
55337-4436
US

V. Phone/Fax

Practice location:
  • Phone: 952-484-3429
  • Fax: 612-324-8988
Mailing address:
  • Phone: 952-484-3429
  • Fax: 612-324-8988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number2286291
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2286291
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: