Healthcare Provider Details

I. General information

NPI: 1366352098
Provider Name (Legal Business Name): MADELINE LOBECK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

308 HARVARD ST SE DENSFORD HALL, ROOM 5-140
MINNEAPOLIS MN
55455
US

IV. Provider business mailing address

1118 MAINSTREET APT 302
HOPKINS MN
55343-2218
US

V. Phone/Fax

Practice location:
  • Phone: 800-598-8636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2485002
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: