Healthcare Provider Details
I. General information
NPI: 1467339622
Provider Name (Legal Business Name): UNITED FAMILY PRACTICE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1897 DELAWARE AVE
SAINT PAUL MN
55118-4338
US
IV. Provider business mailing address
1026 7TH ST W
SAINT PAUL MN
55102-3828
US
V. Phone/Fax
- Phone: 651-758-9500
- Fax:
- Phone: 651-758-9500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LORI
ANN
ZOOK
Title or Position: CFO
Credential:
Phone: 651-758-9500