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NPI Code Detail

MEDICARE: MAGGIE LAGE NP

MEDICARE: MAGGIE LAGE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner8168MN
2363L00000XNurse Practitioner8168MN

General Provider Information

NPI Number : 1093398133
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAGGIE LAGE NP
Provider Business Mailing Address
First Line : 8170 33RD AVE S
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55425-4516
Country : US
Telephone Number : 952-883-6959
Fax Number : 952-853-8831
Provider Business Practice Location Address
First Line : 8170 33RD AVE S
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55425-4516
Country : US
Telephone Number : 952-883-6959
Fax Number : 952-853-8831
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2021
Last Update Date : 01/13/2026

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Directions to “ MAGGIE LAGE NP” Practice Location

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