Provider Demographics
NPI:1306529961
Name:PIIC CLINICAL SERVICES
Entity type:Organization
Organization Name:PIIC CLINICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP CLIENT & CARE STRATEGY
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALSNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:952-698-9860
Mailing Address - Street 1:1500 59TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2614
Mailing Address - Country:US
Mailing Address - Phone:952-698-9860
Mailing Address - Fax:866-470-1873
Practice Address - Street 1:1500 59TH AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2614
Practice Address - Country:US
Practice Address - Phone:952-698-9860
Practice Address - Fax:866-470-1873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care