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General NPI Number Information
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NPI Number | 1023026788
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Entity Type | Individual
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Provider Name | ARICA ANN LOGEAIS OD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1731 17TH AVE E SHAKOPEE VISION CLINIC
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City | SHAKOPEE
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State | MN
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Zip | 55379-3372
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Country | US
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Telephone | 952-445-5600
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Fax | 952-445-5629
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Provider Business Mailing Address
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Address Line | 1275 RAMSEY ST STE 700
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City | SHAKOPEE
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State | MN
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Zip | 55379-3131
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Country | US
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Telephone | 952-222-3937
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Fax | 952-222-2204
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2690
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License Number State | MN
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