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General NPI Number Information
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NPI Number | 1093131419
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Entity Type | Organization
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Legal Business Name | GERIATRIC SERVICES OF MINNESOTA, LLC
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 3433 BROADWAY ST NE STE 300
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-1761
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Country | US
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Telephone | 763-587-7737
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Fax | 651-383-4551
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Provider Business Mailing Address
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Address Line | 3433 BROADWAY ST NE SUITE 300
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-1761
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Country | US
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Telephone | 763-587-7737
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Fax | 763-587-7781
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Authorized Official
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Title or Position | CEO
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Name | JULIA CRIST
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Credential | MHA
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Telephone | 763-587-7737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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