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 provides Family Nurse Practitioner services 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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