Healthcare Provider Details

I. General information

NPI: 1770496606
Provider Name (Legal Business Name): ELSA MAUREEN CARLSON WINSLOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 JACKSON ST NE STE 100
MINNEAPOLIS MN
55413-3051
US

IV. Provider business mailing address

1069 GLENHILL RD
SHOREVIEW MN
55126-8115
US

V. Phone/Fax

Practice location:
  • Phone: 612-353-6293
  • Fax:
Mailing address:
  • Phone: 612-816-5356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberDOUL-438
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: