Mina Skilled Nursing LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MINA SKILLED NURSING LLC

Practice address

1111 112TH Ave NE
Blaine, MN 55434-0009

Phone

(612) 806-8397

NPI assigned

Nov 10, 2025

Organization subpart

No

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

Authorized official

Name

Khadra Esse

Title

Owner/Manager

Phone

(612) 806-8397

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1871463133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 112TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554340009",
            "telephone_number": "612-806-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 112TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554340009",
            "telephone_number": "612-806-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINA SKILLED NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "ESSE",
        "authorized_official_first_name": "KHADRA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "612-806-8397"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.