Healthcare Provider Details

I. General information

NPI: 1205645777
Provider Name (Legal Business Name): JANUS LEPC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5424 KNOX AVE S
MINNEAPOLIS MN
55419-1502
US

IV. Provider business mailing address

5424 KNOX AVE S
MINNEAPOLIS MN
55419-1502
US

V. Phone/Fax

Practice location:
  • Phone: 612-741-5154
  • Fax: 612-928-9182
Mailing address:
  • Phone: 612-741-5154
  • Fax: 612-928-9182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: NICOLE NAVARRETE
Title or Position: REVENUE CYCLE MANAGEMENT CONSULTANT
Credential:
Phone: 612-479-2215