Healthcare Provider Details

I. General information

NPI: 1174431415
Provider Name (Legal Business Name): PAETON MORROW CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9855 HOSPITAL DR STE 102A
MAPLE GROVE MN
55369
US

IV. Provider business mailing address

9855 HOSPITAL DR STE 102A
MAPLE GROVE MN
55369
US

V. Phone/Fax

Practice location:
  • Phone: 763-581-5800
  • Fax: 763-581-9221
Mailing address:
  • Phone: 763-581-5800
  • Fax: 763-581-9221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14719
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: