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Contact Information

EAGAN CHILD AND FAMILY CARE, P.A.
4178 KNOB DR
SUITE A
EAGAN, MN55122-2888
 Phone: 651-209-8640
 Fax: 651-209-8690
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Women's Health

363LW0102X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for EAGAN CHILD AND FAMILY CARE, P.A.

NPI # 1629000682
LBN Legal business name EAGAN CHILD AND FAMILY CARE, P.A.
Authorized official GRETCHEN MOEN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/07/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
MN License # 1650
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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