MEDICARE: MACKENSIE EDER LPN

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	164W00000X	Licensed Practical Nurse	820592	MN

General Provider Information

NPI Number	:	1437774437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENSIE EDER LPN

Provider Business Mailing Address
First Line	:	12310 SINGLETREE LN APT 2334
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-7983
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12310 SINGLETREE LN APT 2334
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-7983
Country	:	US
Telephone Number	:	612-322-0990
Fax Number	:

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

Provider Enumeration Date	:	06/15/2020
Last Update Date	:	06/15/2020

Similar Medicare Providers

1689488389 — JMI RECUPERATIVE CARE LLC
Practice Location Address:

12310 SINGLETREE LN APT 2344
EDEN PRAIRIE, MN
55344-7983

Practice Phone: 585-967-1794
Practice Fax:

1184587016 — DANEA DAVIS
Practice Location Address:

10180 VIKING DR
EDEN PRAIRIE, MN
55344-7207

Practice Phone: 612-416-1301
Practice Fax:

1831052646 — ABBIE LUPELOW
Practice Location Address:

6640 SHADY OAK RD STE 401
EDEN PRAIRIE, MN
55344-7834

Practice Phone: 715-256-7166
Practice Fax: 888-427-8048

1275022618 — SAMANTHA ANNA WLOCH PHYSICIAN ASSISTANT
Practice Location Address:

7595 ANAGRAM DR
EDEN PRAIRIE, MN
55344-7399

Practice Phone: 612-573-2200
Practice Fax: 612-573-2274

1336692888 — SPENCER LINDHOLM D.C.
Practice Location Address:

9721 VALLEY VIEW RD
EDEN PRAIRIE, MN
55344-3508

Practice Phone: 952-777-3709
Practice Fax:

1205103207 — DR. SARAH L MALLAK PHARM.D.
Practice Location Address:

1 OPTUM CIR
EDEN PRAIRIE, MN
55344-2956

Practice Phone: 800-519-1139
Practice Fax:

Directions to “ MACKENSIE EDER LPN” 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.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.