Healthcare Provider Details

I. General information

NPI: 1699951079
Provider Name (Legal Business Name): PEOPLE ENHANCING PEOPLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 UNIVERSITY AVE W 301
SAINT PAUL MN
55104-3898
US

IV. Provider business mailing address

1600 UNIVERSITY AVE W 301
SAINT PAUL MN
55104-3898
US

V. Phone/Fax

Practice location:
  • Phone: 651-450-5960
  • Fax:
Mailing address:
  • Phone: 651-450-5960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMN

VIII. Authorized Official

Name: MS. JUDY ELLING
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 651-450-5960