Mirabilis Health
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Walker, MN
NPI 1922816883 · NPPES record last updated Dec 24, 2024
Key facts
- NPI
- 1922816883
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- MIRABILIS HEALTH
- Practice address
- 7981 Town Hall Rd NW
Walker, MN 56484-2117 - Phone
- (320) 223-0260
- NPI assigned
- Dec 24, 2024
- Organization subpart
- No
Authorized official
- Name
- Mary Jean McCarthy, APRN
- Title
- Pmhnp-BC, Owner
- Phone
- (320) 223-0260
Practitioners 2
-
Mary J McCarthy, APRN, CNP
-
Danielle Cotter, LMFT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250410000877 | MN | Part B Supplier - Clinic/Group Practice | 5496279572 |
Receives reassigned benefits from 1 practitioner Practice locations: Walker, MN |
National Provider Directory
Locations
7981 Town Hall Rd NW
Walker, MN 56484
Phone (320) 223-0260
1001 Minnesota Ave W
Ste 101
Walker, MN 56484
Phone (320) 223-0260
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
7981 Town Hall Rd NW
Walker, MN 56484-2117
Mailing address
8990 70TH Ave NW
Walker, MN 56484-2069
Phone (320) 223-0260
Other providers in Walker, MN
- May Creek Lodge Inc.
- Kathryn A Mell
- Michael T. Pederson, DDS
- Katherine Marie Miller
- Vanessa Jane Miller
- Michael R Noonan
- James D Olander
- Park Rapids Walker Eye Clinic O.D., P.a.
- Amanda Pederson
- Michael Todd Pederson
All providers in Walker, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.