Healthcare Provider Details

I. General information

NPI: 1942117544
Provider Name (Legal Business Name): LOREDANA MORETT HERBST HEALTH AND WELLNESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12575 84TH PL N
MAPLE GROVE MN
55369-4787
US

IV. Provider business mailing address

12575 84TH PL N
MAPLE GROVE MN
55369-4787
US

V. Phone/Fax

Practice location:
  • Phone: 763-424-1224
  • Fax:
Mailing address:
  • Phone: 763-424-1224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3760865
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: