Healthcare Provider Details

I. General information

NPI: 1164318689
Provider Name (Legal Business Name): MEGAN SALTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 LILAC DR N
GOLDEN VALLEY MN
55422-4700
US

IV. Provider business mailing address

820 LILAC DR N
GOLDEN VALLEY MN
55422-4700
US

V. Phone/Fax

Practice location:
  • Phone: 763-465-0500
  • Fax: 763-465-0588
Mailing address:
  • Phone: 763-465-0500
  • Fax: 763-465-0588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12918
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: