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General NPI Number Information
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NPI Number | 1467308304
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Entity Type | Organization
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Legal Business Name | WHOLEMIND WELLNESS AND PSYCHIARTY
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 20731 HOLYOKE AVE
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City | LAKEVILLE
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State | MN
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Zip | 55044-9825
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Country | US
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Telephone | 507-319-2879
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Fax |
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Provider Business Mailing Address
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Address Line | 20731 HOLYOKE AVE
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City | LAKEVILLE
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State | MN
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Zip | 55044-9825
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Country | US
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Telephone | 507-319-2879
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH NURSE PRACTTIONER
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Name | FADUMO H HERSI
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Credential | DNP/APRN
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Telephone | 507-319-2879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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