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ST CATHERINE UNIVERSITY NPI 1891016481


NPI Information

NPI: 1891016481
Provider Name: ST CATHERINE UNIVERSITY

Doing Business As: ST CATHERINE UNIVERSITY HEALTH AND WELLNESS CENTER

Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 24D0667911

Address:
2004 RANDOLPH AVE
MAIL #4112
SAINT PAUL, MN
ZIP 55105
Phone: (651) 690-6714
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ST CATHERINE UNIVERSITY is an adolescent medicine pediatrics in Saint Paul, MN. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. ST CATHERINE UNIVERSITY NPI is 1891016481. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As St Catherine University Health And Wellness Center.

The provider's business location address is:

2004 RANDOLPH AVE
MAIL #4112
SAINT PAUL, MN
ZIP 55105-750
Phone: (651) 690-6714
Fax: (651) 690-6188

The provider's authorized official is Amy M Kelly .
The authorized official title is Md and has the following contact phone number (651) 690-6714.

The CLIA number assigned to this NPI record is 24D0667911 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/17/2010 and was last updated on 6/17/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080A0000XPediatricsAdolescent Medicine40727MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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