MEDICARE: CONSULT CARE LLC

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
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1245504117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONSULT CARE LLC

Provider Business Mailing Address
First Line	:	18521 PHEASANT RIDGE RD
Second Line	:
City	:	PRIOR LAKE
State	:	MN
Zip	:	55372-9705
Country	:	US
Telephone Number	:	651-238-6097
Fax Number	:

Provider Business Practice Location Address
First Line	:	18521 PHEASANT RIDGE RD
Second Line	:
City	:	PRIOR LAKE
State	:	MN
Zip	:	55372-9705
Country	:	US
Telephone Number	:	651-238-6097
Fax Number	:

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	SHEILA ANN HOWES-TRAMMEL
Credential	:
Telephone Number	:	651-238-6097

Provider Enumeration Date	:	02/23/2012
Last Update Date	:	02/23/2012

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