| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1871925479 | JOHNSON | CARLA | RAE | 9201 W BROADWAY AVE | BROOKLYN PARK | MN | 554451923 | |
| 1245537869 | NGWA | NGUM | A | 9201 W BROADWAY AVE | BROOKLYN PARK | MN | 554451923 | |
| 1518399294 | STASSEN | DEBRA | LOU | 9201 W BROADWAY AVE | BROOKLYN PARK | MN | 554451923 |