Healthcare Provider Details

I. General information

NPI: 1952355877
Provider Name (Legal Business Name): MEDICAL PROFESSIONALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 LITTLE CANADA RD W STE 312
LITTLE CANADA MN
55117-1387
US

IV. Provider business mailing address

93 LITTLE CANADA RD W STE 312
LITTLE CANADA MN
55117-1387
US

V. Phone/Fax

Practice location:
  • Phone: 763-318-6940
  • Fax: 651-288-0214
Mailing address:
  • Phone: 763-318-6940
  • Fax: 651-288-0214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHE 01084 04
License Number StateMN

VIII. Authorized Official

Name: MR. SHEKHAR NEPAL
Title or Position: ADMINISTRATOR
Credential:
Phone: 651-288-0222