MEDICARE: THE NEIGHBORHOOD NP 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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1396680773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NEIGHBORHOOD NP LLC

Provider Business Mailing Address
First Line	:	4011 COLFAX AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55412-1729
Country	:	US
Telephone Number	:	612-438-4188
Fax Number	:	612-438-4188

Provider Business Practice Location Address
First Line	:	4011 COLFAX AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55412-1729
Country	:	US
Telephone Number	:	612-438-4188
Fax Number	:	612-438-4188

Authorized Official
Title or Position	:	OWNER
Name	:	SHAREEF WALI OMAR TAYLOR
Credential	:	CNP
Telephone Number	:	612-438-4188

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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