| Gillette Children's Healthcare-burnsville | |
|
305 E Nicollet Blvd Suite 200 Burnsville MN 55337-8327 | |
| (952) 223-3400 | |
| (952) 223-3405 |
| Full Name | Gillette Children's Healthcare-burnsville |
|---|---|
| Speciality | Clinic/Center |
| Location | 305 E Nicollet Blvd, Burnsville, Minnesota |
| Authorized Official Name and Position | Patrick Nolan (CFO) |
| Authorized Official Contact | 6513123105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gillette Children's Healthcare-burnsville 200 University Ave E Saint Paul MN 55101-2507 Ph: (651) 291-2848 | Gillette Children's Healthcare-burnsville 305 E Nicollet Blvd Suite 200 Burnsville MN 55337-8327 Ph: (952) 223-3400 |
| NPI Number | 1740349042 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 12/13/2019 |
| Medicare PECOS PAC ID | 0547169211 |
|---|---|
| Medicare Enrollment ID | O20100930035868 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740349042 | NPI | - | NPPES |
| 41683100 | Medicaid | WI | |
| 578182000 | Medicaid | MN | |
| 366138000 | Medicaid | MN | |
| 11003700 | Medicaid | WI | |
| 1111HGI | Other | BLUE CROSS BLUE SHIELD |
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