Basic Information
| Provider Information | |||||||||
| NPI: | 1336145937 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOUIE | ||||||||
| FirstName: | SHERYL | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 NICOLLET MALL STE 400 | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554022520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123332503 | ||||||||
| FaxNumber: | 6123337080 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 W 66TH ST STE 385 | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554352197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529276561 | ||||||||
| FaxNumber: | 9529276569 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2005 | ||||||||
| LastUpdateDate: | 09/28/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 42216 | MN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 110113700 | 05 | MN | MEDICAID |