Active NPI
Mavis Nkansah
- Nurse's Aide
- Savage, MN
National Provider Identifier
1295562619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 10635651
- Practice address
- 14039 Virginia Ave
Savage, MN 55378-6405 - Phone
- (719) 725-0712
- Fax
- (000) 000-0000
- NPI assigned
- Sep 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 10635651 | MN | Primary |
Addresses
Primary practice location
14039 Virginia Ave
Savage, MN 55378-6405
Mailing address
11011 Anderson Lakes Pkwy Apt 305N
Eden Prairie, MN 55344-4112
Phone (952) 457-1836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10635651 | MN | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1295562619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11011 ANDERSON LAKES PKWY APT 305N",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553444112",
"telephone_number": "952-457-1836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14039 VIRGINIA AVE",
"city": "SAVAGE",
"state": "MN",
"postal_code": "553786405",
"telephone_number": "719-725-0712",
"fax_number": "000-000-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NKANSAH",
"first_name": "MAVIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-18",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "MN",
"license": "10635651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savage, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.