Healthcare Provider Details

I. General information

NPI: 1184583551
Provider Name (Legal Business Name): AVERI ELIZABETH WALSH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 MAIN ST W
MELROSE MN
56352-1043
US

IV. Provider business mailing address

525 MAIN ST W
MELROSE MN
56352-1043
US

V. Phone/Fax

Practice location:
  • Phone: 320-256-4231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2492952
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: