Healthcare Provider Details

I. General information

NPI: 1548068968
Provider Name (Legal Business Name): NORTH STAR MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 HIGHWAY 96 E STE 102
WHITE BEAR LAKE MN
55110-3651
US

IV. Provider business mailing address

1330 HIGHWAY 96 E STE 102
WHITE BEAR LAKE MN
55110-3651
US

V. Phone/Fax

Practice location:
  • Phone: 763-999-4340
  • Fax:
Mailing address:
  • Phone: 763-999-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BIANCA BIANCHI-ROSSI
Title or Position: CO-OWNER
Credential: DC
Phone: 612-240-7137