Healthcare Provider Details

I. General information

NPI: 1770957219
Provider Name (Legal Business Name): HENNEPIN HEALTHCARE SYSTEM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 S 8TH ST, SL10
MINNEAPOLIS MN
55404-1284
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 612-352-1294
  • Fax:
Mailing address:
  • Phone: 612-873-3000
  • Fax: 612-904-4259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number376132
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number376132
License Number StateMN

VIII. Authorized Official

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