Healthcare Provider Details

I. General information

NPI: 1225455595
Provider Name (Legal Business Name): MARGARET NOVAK CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 LONGFELLOW AVE
MINNEAPOLIS MN
55407-3637
US

IV. Provider business mailing address

4500 LONGFELLOW AVE
MINNEAPOLIS MN
55407-3637
US

V. Phone/Fax

Practice location:
  • Phone: 612-251-1746
  • Fax:
Mailing address:
  • Phone: 612-251-1746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: