Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Summit Advance Mobile Wound Care LLC

Organization Family Nurse Practitioner · NPI 1316759566

Summit Advance Mobile Wound Care LLC is a Family Nurse Practitioner in Maple Grove, Minnesota. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6773 Deerwood Ln N
Maple Grove, MN 55369-5530
Phone: (612) 598-8555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1316759566
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Henry Momanyi — Nurse Practitioner · (612) 598-8555
NPI enumeratedJanuary 24, 2025
Last updated in NPPESJanuary 24, 2025
Certification dateJanuary 24, 2025
Mailing address6773 Deerwood Ln N, Maple Grove, MN 55369-5530

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