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NPI Code Detail

MEDICARE: NEIGHBORHOOD HEALTHSOURCE

MEDICARE: NEIGHBORHOOD HEALTHSOURCE
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
1208D00000XGeneral Practice Physician
2261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1386682078
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEIGHBORHOOD HEALTHSOURCE
Provider Business Mailing Address
First Line : 3300 FREMONT AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-2405
Country : US
Telephone Number : 612-588-9411
Fax Number : 612-522-6627
Provider Business Practice Location Address
First Line : 3300 FREMONT AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-2405
Country : US
Telephone Number : 612-588-9411
Fax Number : 612-522-6627
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. STEVE J KNUTSON
Credential :
Telephone Number : 612-287-2428
Provider Enumeration Date : 06/03/2006
Last Update Date : 06/29/2023

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Directions to “NEIGHBORHOOD HEALTHSOURCE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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