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NPI Code Detail

MEDICARE: MICHAEL AINES APRN

MEDICARE: MICHAEL AINES APRN
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
1363L00000XNurse Practitioner3003280KY
2363LF0000XFamily Nurse Practitioner3003280KY

General Provider Information

NPI Number : 1184614901
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL AINES APRN
Provider Business Mailing Address
First Line : PO BOX 1459
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55440-1459
Country : US
Telephone Number : 478-538-0908
Fax Number :
Provider Business Practice Location Address
First Line : 9900 BREN RD E
Second Line :
City : MINNETONKA
State : MN
Zip : 55343-9664
Country : US
Telephone Number : 478-538-0908
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 06/22/2020

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