Healthcare Provider Details

I. General information

NPI: 1427410778
Provider Name (Legal Business Name): HOA LY TRINH CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOA BOI LY

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 CHICAGO AVE STE 500
MINNEAPOLIS MN
55404-4291
US

IV. Provider business mailing address

2530 CHICAGO AVE STE 500
MINNEAPOLIS MN
55404-4291
US

V. Phone/Fax

Practice location:
  • Phone: 612-813-8000
  • Fax: 612-813-8005
Mailing address:
  • Phone: 612-813-8000
  • Fax: 612-813-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCNP 4415
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: