1659052934 NPI number — LAURA LOUISE BATISTA DE OLIVEIRA RN

Table of content: LAURA LOUISE BATISTA DE OLIVEIRA RN (NPI 1659052934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659052934 NPI number — LAURA LOUISE BATISTA DE OLIVEIRA RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BATISTA DE OLIVEIRA
Provider First Name:
LAURA
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HELLMUTH
Provider Other First Name:
LAURA
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659052934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10637 VESSEY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLOOMINGTON
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55437-2720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-368-0735
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
M HEALTH FAIRVIEW RIDGES
Provider Second Line Business Practice Location Address:
201 EAST NICOLLET BLVD
Provider Business Practice Location Address City Name:
BURNSVILLE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-892-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN2499879 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)