Healthcare Provider Details

I. General information

NPI: 1043174055
Provider Name (Legal Business Name): WILLA HEALTHCARE FAMILY CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 EGAN DR
SAVAGE MN
55378-4917
US

IV. Provider business mailing address

7635 148TH ST W # 183
APPLE VALLEY MN
55124-7800
US

V. Phone/Fax

Practice location:
  • Phone: 952-288-4626
  • Fax: 651-331-3107
Mailing address:
  • Phone: 651-308-9147
  • Fax: 651-305-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. UCHE FRANKLIN
Title or Position: FAMILY NURSE PRACTITIONER
Credential: DNP,APRN,CNP,FNP-BC
Phone: 952-288-4626