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General NPI Number Information
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NPI Number | 1467268250
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Entity Type | Individual
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Provider Name | JASMINE LANAE PRICE
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 5500 94TH AVE N
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City | MINNEAPOLIS
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State | MN
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Zip | 55443-1992
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Country | US
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Telephone | 763-762-2838
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Fax |
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Provider Business Mailing Address
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Address Line | 1660 107TH AVE NW
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City | COON RAPIDS
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State | MN
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Zip | 55433-4285
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Country | US
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Telephone | 651-309-7731
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Fax |
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 2502162
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License Number State | MN
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