Ivora Health Minnesota LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

IVORA HEALTH MINNESOTA LLC

Practice address

703 Willoughby Way W
Hopkins, MN 55305-5344

Phone

(954) 702-3372

NPI assigned

Jan 17, 2021

Organization subpart

No

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

Authorized official

Name

Kaylynn Annis, APRN

Title

President

Phone

(612) 910-1070

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1610841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610841600000",
    "number": "1760071302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 WILLOUGHBY WAY W",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553055344",
            "telephone_number": "954-702-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 WILLOUGHBY WAY W",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553055344",
            "telephone_number": "954-702-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVORA HEALTH MINNESOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-17",
        "last_updated": "2021-01-17",
        "certification_date": "2021-01-17",
        "status": "A",
        "authorized_official_last_name": "ANNIS",
        "authorized_official_first_name": "KAYLYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-910-1070",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Hopkins, MN
• Providers in Hopkins, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2021; 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.