Healthcare Provider Details

I. General information

NPI: 1891077178
Provider Name (Legal Business Name): NIGHTINGALE HOSPICE CARE OF MINNESOTA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10550 WAYZATA BLVD STE 2
MINNETONKA MN
55305-1523
US

IV. Provider business mailing address

1036 S RANGE LINE RD
CARMEL IN
46032-2544
US

V. Phone/Fax

Practice location:
  • Phone: 763-545-3131
  • Fax: 763-546-1191
Mailing address:
  • Phone: 317-334-1111
  • Fax: 317-569-1403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateMN

VIII. Authorized Official

Name: DEV ANUROOP BRAR
Title or Position: OWNER
Credential: M.D.
Phone: 317-334-7777