Provider Demographics
NPI:1205729340
Name:JUNIOR, BIANCA N
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:N
Last Name:JUNIOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4124 QUEBEC AVE N STE 105D
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1200
Mailing Address - Country:US
Mailing Address - Phone:651-815-3819
Mailing Address - Fax:
Practice Address - Street 1:4124 QUEBEC AVE N STE 105D
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1200
Practice Address - Country:US
Practice Address - Phone:651-815-3819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator