Divinia Dewaynia Ellis
Case Manager/Care Coordinator in North St Paul, MN. Individual provider (NPI-1).
NPI number1972454841
StatusActive
Last updated in NPPESFeb 6, 2026
Details
- NPI
- 1972454841
- Entity type
- Individual (NPI-1)
- Name
- Divinia Dewaynia Ellis
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 6, 2026
- Certification date
- Feb 5, 2026
- Last updated
- Feb 6, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | MN | Yes |
Practice location
2365 McKnight Rd NNorth St Paul, MN 55109-2238
Phone 651-370-2373 · Fax 651-370-2373
Mailing address
8430 Yucca Ln NMaple Grove, MN 55369-4671
Phone 651-370-2373 · Fax 651-760-3236
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All 12 Case Manager/Care Coordinator providers in North St Paul · All 148 providers in North St Paul
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