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Organization
PARK NICOLLET CLINIC
Active
Organization
PARK NICOLLET CLINIC
Active
Other names
Park Nicollet Clinic Episodic Bundle
Organization subpart
No
Provider details
NPI number
Authorized official
ALITA RISINGER (SR VICE PRESIDENT, CFO)
(952) 883-5401
Entity
Organization
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3123
(952) 993-2770
Mailing address
3800 PARK NICOLLET BLVD, ATTENTION: BUSINESS SERVICES, ST LOUIS PARK, MN 55416-2527
(952) 993-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
07/27/2015
Last updated
08/03/2026
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