MEDICARE: REGENTS OF THE UNIVERSITY OF MINNESOTA

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	101Y00000X	Counselor	NA	MN

General Provider Information

NPI Number	:	1255534640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENTS OF THE UNIVERSITY OF MINNESOTA

Provider Business Mailing Address
First Line	:	2700 SUMMER ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55413-2820
Country	:	US
Telephone Number	:	612-627-4107
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 SUMMER ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55413-2820
Country	:	US
Telephone Number	:	612-627-4107
Fax Number	:

Authorized Official
Title or Position	:	DEAN OF COLL OF EDUC AND HUM DEV
Name	:	DARLYNE BAILEY
Credential	:
Telephone Number	:	612-626-9252

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	08/22/2020

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