Brenda Harris
Individual provider Active NPI Homemaker · Minneapolis, MN
NPI 1891159943 · NPPES record last updated Apr 20, 2016
Key facts
- NPI
- 1891159943
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- License
- 376J00000X (MN)
- Practice address
- 2225 Ilion Ave N
Minneapolis, MN 55411-1921 - Phone
- (612) 521-9066
- NPI assigned
- Apr 5, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 374U00000X | MN | MD | Home Health Aide |
| 376J00000X | MN | MD | Homemaker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgeway Home Healthcare Ser | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | 376J00000X | MN | Yes |
| Home Health Aide | 374U00000X | 374U00000X | MN |
Addresses
Primary practice location
2225 Ilion Ave N
Minneapolis, MN 55411-1921
Mailing address
2225 Ilion Ave N
Minneapolis, MN 55411-1921
Phone (612) 521-9066
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2016. 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.