| NPI | 1356344451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC NIELSEN Administrator 218-485-4491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 20268) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 36731) |
| 207Q00000X Family Medicine (Licence: MN 36725) | |
| 207Q00000X Family Medicine (Licence: MN 41745) | |
| 207Q00000X Family Medicine (Licence: MN 47303) | |
| 207Q00000X Family Medicine (Licence: MN 33016) | |
| 207Q00000X Family Medicine (Licence: MN 34715) | |
| 207Q00000X Family Medicine (Licence: MN 46671) | |
| 207Q00000X Family Medicine (Licence: MN 54207) | |
| 207R00000X Internal Medicine (Licence: MN 43634) | |
| 208000000X Pediatrics (Licence: MN 43634) | |
| 363A00000X Physician Assistant (Licence: MN 11706) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R 147424-0) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R 137363-9) | |
| 364S00000X Clinical Nurse Specialist (Licence: MN R 108935-0) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2015-10-16 |