Professional Resource Network - PRN - Corporation

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

328388 Issued in MN

Legal business name

PROFESSIONAL RESOURCE NETWORK - PRN - CORPORATION

Doing business as

Professional Resource Network Home Health Care

Practice address

4951 W 77TH St Ste 110
Edina, MN 55435-4802

Phone

(952) 858-8807

NPI assigned

Dec 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charie L Devolites

Title

President

Phone

(952) 858-8807

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Professional Resource Network Home Health Care Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1710045430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "574 PRAIRIE CENTER DR STE 135-279",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447930",
            "telephone_number": "952-858-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 W 77TH ST STE 110",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354802",
            "telephone_number": "952-858-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL RESOURCE NETWORK - PRN - CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "DEVOLITES",
        "authorized_official_first_name": "CHARIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-858-8807"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "328388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "611727900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Resource Network Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Professional Resource Network Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Edina, MN
• Providers in Edina, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.