Healthcare Provider Details
I. General information
NPI: 1336481001
Provider Name (Legal Business Name): MORNING STAR BIRTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2013
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6111 EXCELSIOR BLVD
ST LOUIS PARK MN
55416-2703
US
IV. Provider business mailing address
321 13TH ST SE
MENOMONIE WI
54751-2032
US
V. Phone/Fax
- Phone: 612-922-4784
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QB0400X |
| Taxonomy | Birthing Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAULA
BERNINI FEIGAL
Title or Position: CEO
Credential:
Phone: 715-556-2822