| Genevive | |
|
3433 Broadway St Ne Ste 300 Minneapolis MN 55413-1761 | |
| (763) 587-7737 | |
| (763) 587-7069 |
| Full Name | Genevive |
|---|---|
| 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 | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genevive 3433 Broadway St Ne Ste 300 Minneapolis MN 55413-1761 Ph: (763) 587-7737 | Genevive 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 |
| Certification Date | 12/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760141980 | NPI | - | NPPES |
| 7823459 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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