| Minnesota Wound Care Llc | |
|
3433 Broadway St Ne Ste 300 Minneapolis MN 55413-1761 | |
| (763) 587-7737 | |
| (763) 587-7069 |
| Full Name | Minnesota Wound Care Llc |
|---|---|
| Speciality | General Practice |
| Location | 3433 Broadway St Ne Ste 300, Minneapolis, Minnesota |
| Authorized Official Name and Position | Amanda Tufano (CEO AND TREASURER) |
| Authorized Official Contact | 4692311545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Wound Care Llc 3433 Broadway St Ne Ste 300 Minneapolis MN 55413-1761 Ph: (763) 587-7737 | Minnesota Wound Care Llc 3433 Broadway St Ne Ste 300 Minneapolis MN 55413-1761 Ph: (763) 587-7737 |
| NPI Number | 1760141980 |
|---|---|
| Provider Enumeration Date | 12/15/2021 |
| Last Update Date | 12/15/2021 |
| Medicare PECOS PAC ID | 8224411509 |
|---|---|
| Medicare Enrollment ID | O20220818003699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760141980 | NPI | - | NPPES |
| 7823459 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Sarah Louise Isakson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730128505 PECOS PAC ID: 2365420957 Enrollment ID: I20040709001269 |
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