Healthcare Provider Details

I. General information

NPI: 1346280351
Provider Name (Legal Business Name): BARBARA KELLY GLEASON HAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA KELLY GLEASON M.D.

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 28TH ST, SUITE H2100 MINNEAPOLIS HEART INSTITUTE
MINNEAPOLIS MN
55407
US

IV. Provider business mailing address

920 E 28TH ST, SUITE 300 MINNEAPOLIS HEART INSTITUTE
MINNEAPOLIS MN
55407
US

V. Phone/Fax

Practice location:
  • Phone: 612-775-3030
  • Fax: 612-775-3199
Mailing address:
  • Phone: 612-775-3030
  • Fax: 612-863-1681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number45983
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: