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Organization
LONGEVITY WEIGHT MANAGEMENT CLINIC
Active
Organization
LONGEVITY WEIGHT MANAGEMENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIE LOUISE IKEMAN PA-C (CEO)
(612) 327-2228
Entity
Organization
Contact information
Practice address
16273 BAYWOOD LANE, EDEN PRAIRIE, MN 55346-4302
(612) 327-2228
Mailing address
16526 W 78TH ST STE 188, EDEN PRAIRIE, MN 55346-4302
(612) 327-2228
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
—
NULL
Other
Enumeration date
10/05/2026
Last updated
10/05/2026
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