Healthcare Provider Details

I. General information

NPI: 1053492330
Provider Name (Legal Business Name): COUNTY OF CHISAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6133 402ND ST
NORTH BRANCH MN
55056-6097
US

IV. Provider business mailing address

313 N MAIN ST ROOM 240
CENTER CITY MN
55012
US

V. Phone/Fax

Practice location:
  • Phone: 651-213-5231
  • Fax: 651-213-5401
Mailing address:
  • Phone: 651-213-5639
  • Fax: 651-213-5685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: JILL A BRIGGS
Title or Position: DIRECTOR OF PUBLIC HEALTH
Credential: PHN
Phone: 651-213-5231