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

Ebise Bayisa

Individual provider Child Physical Disabilities Respite Care · NPI 1538745047

Ebise Bayisa is a Child Physical Disabilities Respite Care in Blaine, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2021

Practice location Address checks out

12457 Midway Cir NE
Blaine, MN 55449-6228
Phone: (612) 423-5057
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Child Physical Disabilities Respite Care (primary) Taxonomy 385HR2065X (MN)

Record details

NPI number1538745047
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 23, 2021
Last updated in NPPESMarch 23, 2021
Certification dateMarch 23, 2021
Mailing address12457 Midway Cir Ne, Blaine, MN 55449-6228