Provider Demographics
NPI:1891077178
Name:NIGHTINGALE HOSPICE CARE OF MINNESOTA, INC.
Entity Type:Organization
Organization Name:NIGHTINGALE HOSPICE CARE OF MINNESOTA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEV
Authorized Official - Middle Name:ANUROOP
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-334-7777
Mailing Address - Street 1:1036 S RANGE LINE RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2544
Mailing Address - Country:US
Mailing Address - Phone:317-334-1111
Mailing Address - Fax:317-569-1403
Practice Address - Street 1:10550 WAYZATA BLVD STE 2
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1523
Practice Address - Country:US
Practice Address - Phone:763-545-3131
Practice Address - Fax:763-546-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based