Audra Brown
Individual provider Active NPI Personal Care Attendant · Wayzata, MN
NPI 1750866331 · NPPES record last updated Sep 28, 2018
Key facts
- NPI
- 1750866331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- License
- 1093903502 (MN)
- Practice address
- 801 Twelve Oaks Center Dr Ste 822
Wayzata, MN 55391-4645 - Phone
- (952) 456-6561
- Fax
- (952) 456-6561
- NPI assigned
- Sep 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1093903502 | MN | MD | Personal Care Attendant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant |
3747P1801X | 1093903502 | MN | Yes |
Addresses
Primary practice location
801 Twelve Oaks Center Dr Ste 822
Wayzata, MN 55391-4645
Mailing address
801 Twelve Oaks Center Dr Ste 822
Wayzata, MN 55391-4645
Phone (952) 456-6561
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All providers in Wayzata, MN · Personal Care Attendant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.