MEDICARE: LINNA ANSARY WILKINS

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	374J00000X	Doula
2	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1508674102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINNA ANSARY WILKINS

Provider Business Mailing Address
First Line	:	10311 BRUNSWICK CIR
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55438-1862
Country	:	US
Telephone Number	:	612-209-0636
Fax Number	:

Provider Business Practice Location Address
First Line	:	10311 BRUNSWICK CIR
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55438-1862
Country	:	US
Telephone Number	:	651-421-1317
Fax Number	:

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

Provider Enumeration Date	:	12/28/2024
Last Update Date	:	12/28/2024

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Directions to “ LINNA ANSARY WILKINS ” Practice Location

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