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1001 Johnson Pkwy Ste A1 Saint Paul MN 55106-3655 | |
(651) 888-8306 | |
(651) 447-5369 |
Full Name | |
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Speciality | Family Medicine |
Location | 1001 Johnson Pkwy Ste A1, Saint Paul, Minnesota |
Authorized Official Name and Position | Ramon Nola (OWNER) |
Authorized Official Contact | 3162081871 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1901 Dieter St Saint Paul MN 55109-4413 Ph: (651) 888-8306 | 1001 Johnson Pkwy Ste A1 Saint Paul MN 55106-3655 Ph: (651) 888-8306 |
NPI Number | 1982297065 |
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Provider Enumeration Date | 02/19/2021 |
Last Update Date | 01/29/2022 |
Identifier | Type | State | Issuer |
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1982297065 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |