Healthcare Provider Details

I. General information

NPI: 1225971476
Provider Name (Legal Business Name): REPROHEALTH,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 MARGARET ST
ST PAUL MN
55119
US

IV. Provider business mailing address

2688 RICE ST UNIT 2053
LITTLE CANADA MN
55113-2201
US

V. Phone/Fax

Practice location:
  • Phone: 763-273-3770
  • Fax:
Mailing address:
  • Phone: 763-273-3770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DER VUE
Title or Position: CLINICIAN
Credential: NP
Phone: 763-273-3770