Divinia Dewaynia Ellis
Individual provider Active NPI Case Manager/Care Coordinator · North St Paul, MN
NPI 1972454841 · NPPES record last updated Feb 6, 2026
Key facts
- NPI
- 1972454841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 2365 McKnight Rd N
North St Paul, MN 55109-2238 - Phone
- (651) 370-2373
- Fax
- (651) 370-2373
- NPI assigned
- Feb 6, 2026
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | MN | Yes |
Addresses
Primary practice location
2365 McKnight Rd N
North St Paul, MN 55109-2238
Mailing address
8430 Yucca LN N
Maple Grove, MN 55369-4671
Phone (651) 370-2373
Other providers in North St Paul, MN
- Jane Cowley
- Amy Lynn Dahlen
- Robin S Deans
- Madelyn Dornfeld
- Ellie Duncan
- Abbey Katherine Erwin
- Natalie Flora Eull
- Bintu Fahnbulleh
- Family Healthservices Minnesota, P.a.
- Lynda Leone Felver
All providers in North St Paul, MN · Case Manager/Care Coordinator in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2026. 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.