Healthcare Provider Details

I. General information

NPI: 1588930853
Provider Name (Legal Business Name): BABY LOVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 03/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4590 SCOTT TRL STE 200
EAGAN MN
55122-4041
US

IV. Provider business mailing address

4590 SCOTT TRL STE 200
EAGAN MN
55122-4041
US

V. Phone/Fax

Practice location:
  • Phone: 651-200-3343
  • Fax:
Mailing address:
  • Phone: 651-200-3343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: MRS. VERONICA SUE JACOBSEN
Title or Position: CO-OWNER
Credential: BA, LCCE, CPST
Phone: 651-200-3343