MEDICARE: AN MEDI-ZEN

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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1760116776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AN MEDI-ZEN

Provider Business Mailing Address
First Line	:	9354 ENSIGN AVE S
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55438-1455
Country	:	US
Telephone Number	:	952-261-3542
Fax Number	:

Provider Business Practice Location Address
First Line	:	9354 ENSIGN AVE S
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55438-1455
Country	:	US
Telephone Number	:	952-261-3542
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHARON JOHNSON-EBY
Credential	:	DOCTOR
Telephone Number	:	952-465-2450

Provider Enumeration Date	:	07/14/2022
Last Update Date	:	04/30/2024

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Directions to “AN MEDI-ZEN ” Practice Location

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