| Dagan Wellness Llc | |
|
311 W Lake St Minneapolis MN 55408-3026 | |
| (952) 210-7996 | |
| Not Available |
| Full Name | Dagan Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 311 W Lake St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Jacquelyn Lee Denardo (OWNER) |
| Authorized Official Contact | 9522107996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dagan Wellness Llc 311 W Lake St Minneapolis MN 55408-3026 Ph: (952) 210-7996 | Dagan Wellness Llc 311 W Lake St Minneapolis MN 55408-3026 Ph: (952) 210-7996 |
| NPI Number | 1982065983 |
|---|---|
| Provider Enumeration Date | 03/17/2016 |
| Last Update Date | 06/05/2025 |
| Medicare PECOS PAC ID | 3375842115 |
|---|---|
| Medicare Enrollment ID | O20160429001268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982065983 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Ayan A Hassan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962808857 PECOS PAC ID: 2163724766 Enrollment ID: I20160113000528 |
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