Healthcare Provider Details

I. General information

NPI: 1942241765
Provider Name (Legal Business Name): LINDA A EGWIM ANP, GNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA A NDUBIZU ANP, GNP

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 10/12/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

IV. Provider business mailing address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

V. Phone/Fax

Practice location:
  • Phone: 612-873-2720
  • Fax: 612-904-4243
Mailing address:
  • Phone: 612-873-6005
  • Fax: 612-630-8242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number355725-21
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number352079-23
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: