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General NPI Number Information
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NPI Number | 1578368429
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Entity Type | Organization
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Legal Business Name | CENTURIES HEALTH LLC
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 2400 WASHINGTON AVE
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City | CLOQUET
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State | MN
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Zip | 55720-2844
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Country | US
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Telephone | 218-878-1180
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Fax |
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Provider Business Mailing Address
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Address Line | 901 EAGLE RIDGE TRL
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City | STILLWATER
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State | MN
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Zip | 55082-9121
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Country | US
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Telephone | 651-468-8371
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Fax |
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Authorized Official
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Title or Position | OWNER/NP
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Name | MS. MELISSA ANN HILL
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Credential | NP
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Telephone | 651-468-8371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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