Healthcare Provider Details

I. General information

NPI: 1578832457
Provider Name (Legal Business Name): HEATHER PAIGE HARPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 WAYZATA BLVD SUITE 255
ST LOUIS PARK MN
55416-1222
US

IV. Provider business mailing address

5775 WAYZATA BLVD SUITE 200
ST LOUIS PARK MN
55416-1222
US

V. Phone/Fax

Practice location:
  • Phone: 952-525-4500
  • Fax: 952-525-1560
Mailing address:
  • Phone: 952-525-4511
  • Fax: 952-525-1560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberR190690-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: