| NPI | 1710927066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARTINSON Director, Revenue Management 651-696-5676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 01898) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: IA F103607) |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2025-09-23 |