Healthcare Provider Details

I. General information

NPI: 1639286545
Provider Name (Legal Business Name): RICHARD JOSEPH BIANSKI RN, OPA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6363 FRANCE AVE S SUITE 404
EDINA MN
55435-2129
US

IV. Provider business mailing address

6465 WAYZATA BLVD SUITE 900
ST LOUIS PARK MN
55426-1728
US

V. Phone/Fax

Practice location:
  • Phone: 952-927-4525
  • Fax: 952-927-7554
Mailing address:
  • Phone: 952-512-5600
  • Fax: 952-512-5650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberR1077692
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: