Healthcare Provider Details

I. General information

NPI: 1962468280
Provider Name (Legal Business Name): UNA M EDWARDSON ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 SMITH AVE N SUITE 600
SAINT PAUL MN
55102-2424
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-7246
  • Fax: 651-241-7272
Mailing address:
  • Phone: 612-262-4813
  • Fax: 612-262-5419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR133567-7
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: