Provider Demographics
NPI:1649593716
Name:AMY E JOHNSON-GRASS
Entity Type:Organization
Organization Name:AMY E JOHNSON-GRASS
Other - Org Name:TWIN CITIES BIRTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:KEEN-CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-895-2520
Mailing Address - Street 1:968 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105
Mailing Address - Country:US
Mailing Address - Phone:651-895-2520
Mailing Address - Fax:651-330-3768
Practice Address - Street 1:968 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105
Practice Address - Country:US
Practice Address - Phone:651-895-2520
Practice Address - Fax:651-330-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing