GRACE EDITH LINE (NPI# 1790318186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790318186 |
| Entity Type | Individual |
| Full Name | GRACE EDITH LINE |
| Practice Address |
2934 168th Ln Nw Andover MN 55304-1928 |
| Mailing Address |
Po Box 15192 Duluth MN 55815-0192 |
| Practice Telephone | 2184815357 |
| Mailing Telephone | 2184815357 |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2020-02-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172A00000X | Driver | B772-020-465-216 | MN | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6588 Fredenberg Lake Rd, Duluth, MN 558039468 | 2184815357 |
| Street Address |
2934 168TH LN NW |
| City | ANDOVER |
| State | MN |
| Zip Code | 55304-1928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114402211 | Sarah Sue Anderson | Speech-Language Pathologist | 1891 Station Pkwy, Andover, MN 55304 | 2018-09-25 |
| 1306354329 | Jennifer Lynn Larkey I | Counselor | 1875 Station Parkway N.w. Andover, Mn 55304, Andover, MN 55304 | 2018-01-11 |
| 1124544895 | Msp Dentistry Inc | Preferred Provider Organization | 13650 Hanson Blvd., Suite #110, Andover, MN 55304 | 2017-08-15 |
| 1912427931 | Brooke Nicole Halliday | Counselor | 1875 Station Pkwy Ne, Andover, MN 55304 | 2017-06-21 |
| 1700286903 | Jari Welle, Inc. | Marriage & Family Therapist | 1328 Mckay Drive Ne, Suite 100, Ham Lake, MN 55304 | 2014-08-26 |
| 1356765192 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1889 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1326462177 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1899 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1740619568 | Delores Weikle | Physical Therapist | 14531 Jay St, Andover, MN 55304 | 2013-11-02 |
| 1730527003 | Darkou Care Services | Home Health | 14297 Zilla Street Nw, Andover, MN 55304 | 2013-06-10 |
| 1770927758 | Arbor Oaks Senior Living | Assisted Living Facility | 1640 155th Lane Nw, Andover, MN 55304 | 2013-04-22 |
| Find all providers in zip 55304 | ||||
| Taxonomy Code | 172A00000X |
| Grouping | Other Service Providers |
| Classification | Driver |
| A person employed to operate a motor vehicle as a carrier of persons or property. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972078673 | Sanjaya P Perera | Driver | 649 S Cherrywood Cir, Andover, KS 67002-8948 | 2018-10-09 |
| 1861975765 | Kenyi Okucu | Driver | 1490 148th Ave Nw, Andover, MN 55304-3459 | 2018-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093322273 | Melissa Jo Dahlstrom | Driver | 185 Hidden Vly, Minnesota City, MN 55959-1231 | 2020-09-30 |
| 1346866100 | Oral M Sledge | Driver | 4261 Penn Ave N, Minneapolis, MN 55412-1537 | 2020-06-17 |
| 1548813447 | Camille Krashawn Eubanks | Driver | 6444 84thcourt, Brooklyn Park, MN 55445 | 2019-07-19 |
| 1174180640 | Kathryn L Pederson | Driver | 22329 141st St Ne, Hawick, MN 56273-7705 | 2019-05-21 |
| 1336606912 | Oluseye Akeem Adenusi | Driver | 6609 Hillsboro Ave N, Brooklyn Park, MN 55428-1862 | 2019-03-01 |
| 1710444146 | Abdi Fatah | Driver | 2509 Pillsbury Ave S Apt 208, Minneapolis, MN 55404-4206 | 2019-02-21 |
| 1932665403 | Mark Shea | Driver | 17242 Horizon Trl Se, Prior Lake, MN 55372-3939 | 2019-02-20 |
| 1013498872 | Nebiyu Jamal Fanta | Driver | 478 University Ave W, Saint Paul, MN 55103-1935 | 2018-08-28 |
| 1619456084 | Abdifatah Yusuf Warsame | Driver | 14023 Virginia Ave, Savage, MN 55378 | 2018-08-07 |
| 1972094951 | Adam Firas Alaiwi | Driver | 4111 Central Ave Ne Ste 208a, Columbia Heights, MN 55421-2955 | 2018-05-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.