| Mille Lacs Isanti & Sherburne Cos | |
|
706 1st St Princeton MN 55371-1502 | |
| (763) 389-2422 | |
| (763) 389-9142 |
| Full Name | Mille Lacs Isanti & Sherburne Cos |
|---|---|
| Speciality | Local Education Agency (lea) |
| Location | 706 1st St, Princeton, Minnesota |
| Authorized Official Name and Position | Nicole K Wyganowski (LSN) |
| Authorized Official Contact | 6124190211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mille Lacs Isanti & Sherburne Cos 140 Buchanan St N Ste. 150 Cambridge MN 55008-1638 Ph: (763) 689-3600 | Mille Lacs Isanti & Sherburne Cos 706 1st St Princeton MN 55371-1502 Ph: (763) 389-2422 |
| NPI Number | 1427271089 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 08/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427271089 | NPI | - | NPPES |
| 440643500 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Secondary |
| 251300000X | Local Education Agency (lea) | 8922892 (Minnesota) | Primary |
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