Healthcare Provider Details

I. General information

NPI: 1184542722
Provider Name (Legal Business Name): PAUL LEVANDOWSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 WELLINGTON WAY
EAGAN MN
55122-2961
US

IV. Provider business mailing address

1485 WELLINGTON WAY
EAGAN MN
55122-2961
US

V. Phone/Fax

Practice location:
  • Phone: 651-364-1527
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: