Healthcare Provider Details

I. General information

NPI: 1225499767
Provider Name (Legal Business Name): NATIVE PROFESSIONAL SERVICES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2016
Last Update Date: 03/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 DOUGLAS DR N SUITE 224P
GOLDEN VALLEY MN
55422-4327
US

IV. Provider business mailing address

318 CENTRAL AVE N LL 2
FARIBAULT MN
55021-5394
US

V. Phone/Fax

Practice location:
  • Phone: 507-400-2880
  • Fax: 507-540-0988
Mailing address:
  • Phone: 507-400-2880
  • Fax: 507-540-0988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE KNOWLES
Title or Position: PRESIDENT
Credential:
Phone: 507-400-2880