COLLABORATIVE CARE CONSULTANTS LLC NPI 1972309987

NPI Information

  • NPI: 1972309987
  • Provider Name: COLLABORATIVE CARE CONSULTANTS LLC
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Organization
  • Address: 1057 GRAND AVE FL 2
    SAINT PAUL, MN
    ZIP 55105
  • Phone: (651) 384-1736

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NPI Details

COLLABORATIVE CARE CONSULTANTS LLC is a pediatrics nurse practitioner in Saint Paul, MN. COLLABORATIVE CARE CONSULTANTS LLC NPI is 1972309987. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1057 GRAND AVE FL 2
SAINT PAUL, MN
ZIP 55105-002
Phone: (651) 384-1736
Fax: (651) 666-1507

The provider's authorized official is Gretchen Moen .
The authorized official title is Owner and has the following contact phone number (651) 485-3923.

The enumeration date for this NPI number is 2/20/2025 and was last updated on 7/18/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatricsYes

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: 11/21/2025

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