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General NPI Number Information
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NPI Number | 1306529961
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Entity Type | Organization
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Legal Business Name | PIIC CLINICAL SERVICES
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 1500 59TH AVE N
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2614
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Country | US
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Telephone | 952-698-9860
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Fax | 866-470-1873
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Provider Business Mailing Address
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Address Line | 1500 59TH AVE N
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2614
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Country | US
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Telephone | 952-698-9860
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Fax | 866-470-1873
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Authorized Official
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Title or Position | VP CLIENT & CARE STRATEGY
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Name | KATIE HALSNE
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Credential | RN
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Telephone | 952-698-9860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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