Healthcare Provider Details

I. General information

NPI: 1033274881
Provider Name (Legal Business Name): ANN E GEORGE CNNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CHICAGO AVENUE SOUTH CHILDRENS SPECIALTY CLINIC NICU MPLS
MINNEAPOLIS MN
55404
US

IV. Provider business mailing address

2910 CENTRE POINTE DRIVE 35121A CHILDRENS HEALTH CARE
ROSEVILLE MN
55113
US

V. Phone/Fax

Practice location:
  • Phone: 612-813-6295
  • Fax: 612-813-6949
Mailing address:
  • Phone: 651-855-2327
  • Fax: 651-855-2310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberR0967091
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberR0967091
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: