MEDICARE: MIRANDA HELMERS CNP

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	7510	MN

General Provider Information

NPI Number	:	1366060121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA HELMERS CNP

Provider Business Mailing Address
First Line	:	PO BOX 14909
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-0909
Country	:	US
Telephone Number	:	612-871-1145
Fax Number	:	612-870-5491

Provider Business Practice Location Address
First Line	:	5705 W OLD SHAKOPEE RD STE 150
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55437-3126
Country	:	US
Telephone Number	:	612-871-1145
Fax Number	:	612-870-5491

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2020
Last Update Date	:	07/25/2024

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