Healthcare Provider Details

I. General information

NPI: 1134503493
Provider Name (Legal Business Name): WINNIE YIP PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: WINNIE YIP

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 BLOOMINGTON AVE
MINNEAPOLIS MN
55404-3074
US

IV. Provider business mailing address

1030 MAIN ST NE UNIT 305
MINNEAPOLIS MN
55413-4407
US

V. Phone/Fax

Practice location:
  • Phone: 612-301-3433
  • Fax:
Mailing address:
  • Phone: 208-570-5204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9950
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCOA.17750-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: