# NUCLEUS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982882742
- **Authorized official:** DIANE LYNN HENDRICKSON CEO (CHEIF EXECUTIVE OFFICER)
- **Authorized official phone:** (763) 755-5300

## Contact information

- **Practice address:** 1323 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-5362
- **Practice address phone:** (763) 755-5300
- **Practice address fax:** (763) 755-5301
- **Mailing address:** 1323 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-5362
- **Mailing address phone:** (763) 755-5300
- **Mailing address fax:** (763) 755-5301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/04/2008
- **Last updated:** 02/04/2008