Healthcare Provider Details
I. General information
NPI: 1952232001
Provider Name (Legal Business Name): MAI ANH DOAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1455 SAINT FRANCIS AVE
SHAKOPEE MN
55379-3374
US
IV. Provider business mailing address
1455 SAINT FRANCIS AVE
SHAKOPEE MN
55379-3374
US
V. Phone/Fax
- Phone: 952-428-2121
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P0018X |
| Taxonomy | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| License Number | 123379 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: