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Contact Information

ROSEAU/WARROAD EYE CLINIC, P.A.
306 N MAIN
ROSEAU, MN56751
 Phone: 218-463-2020
 Fax: 218-463-2055
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ROSEAUWARROAD EYE CLINIC PA · (Female)

NPI # 1871679456
Status Active
Credentials
Entity Individual
Enumeration date 10/27/2006
Last updated 08/05/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # 1618
  • MN License # 1693
  • MN License # 2946
  • MN Medicaid 275823700
  • MN Medicaid 295457500
  • MN Medicaid 844323800
  • MN Other 13951 BLUE CROSS BLUE SHIELD
  • MN Other 13962 BLUE CROSS BLUE SHIELD
  • MN Other 192K5YE BLUE CROSS BLUE SHIELD
  • MN Other HP40537 HEALTHPARTNERS
  • MN Other HP42709 HEALTHPARTNERS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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