Healthcare Provider Details

I. General information

NPI: 1750605218
Provider Name (Legal Business Name): LE MIEUX NURSING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 03/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11116 ZEALAND AVE N 204
CHAMPLIN MN
55316-3594
US

IV. Provider business mailing address

11116 ZEALAND AVE N 204
CHAMPLIN MN
55316-3594
US

V. Phone/Fax

Practice location:
  • Phone: 763-746-0845
  • Fax: 763-746-0846
Mailing address:
  • Phone: 763-746-0845
  • Fax: 763-746-0846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number348110
License Number StateMN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MISS CHINYELUM OBI-RAPU
Title or Position: ADMINISTRATOR
Credential:
Phone: 763-746-0845