Healthcare Provider Details

I. General information

NPI: 1407897309
Provider Name (Legal Business Name): HENNEPIN HEALTHCARE SYSTEM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE, P1-FINANCE
MINNEAPOLIS MN
55415-1623
US

IV. Provider business mailing address

701 PARK AVE, P1-FINANCE
MINNEAPOLIS MN
55415-1623
US

V. Phone/Fax

Practice location:
  • Phone: 612-873-3000
  • Fax: 612-904-4259
Mailing address:
  • Phone: 612-873-3000
  • Fax: 612-904-4259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number331373
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number367063
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number367142
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number367063
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0157
License Number StateMN

VIII. Authorized Official

Name: LISA ANDERSON
Title or Position: CFO
Credential:
Phone: 612-873-9505