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General NPI Number Information
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NPI Number | 1649035213
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Entity Type | Organization
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Legal Business Name | HEALINGMED CLINIC LLC
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Dates
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Enumeration Date | 02/14/2024
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1821 UNIVERSITY AVE W STE 107-12
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City | SAINT PAUL
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State | MN
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Zip | 55104-0049
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Country | US
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Telephone | 952-607-0217
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Fax |
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Provider Business Mailing Address
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Address Line | 14369 FAIRWAY DR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-1956
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Country | US
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Telephone | 952-607-0217
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Fax | 800-398-8041
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Authorized Official
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Title or Position | FOUNDER
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Name | NOUSSAIBA AYOUR
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Credential | PA-C
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Telephone | 952-607-0217
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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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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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