Novak, Vicki Rae

Novak, Vicki Rae is an individual health care provider with primary practice located at 8669 Eagle Point Blvd , Lake Elmo MN 55042-8628. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Novak, Vicki Rae can be contacted via phone (651) 379-0444.

Contact Information

Primary practice address
8669 Eagle Point Blvd Lake Elmo MN 55042-8628
Fax: (651) 379-0448
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 445 Minnesota

Profile Details

NPI number 1023150067
LBN Legal business name Novak, Vicki Rae
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2007
Last updated Dec 30th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023150067 NPPES
Minnesota Other 416K6NO BCBS OF MN ID

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