Healthcare Provider Details

I. General information

NPI: 1043195506
Provider Name (Legal Business Name): ANNA JUNE MAHER BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E 1ST ST
DULUTH MN
55805-2906
US

IV. Provider business mailing address

1305 MISSOURI AVE
DULUTH MN
55811-2328
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-4783
  • Fax:
Mailing address:
  • Phone: 715-308-3283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number13386
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number2319977
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: