Organization
PARK NICOLLET CLINIC
Active
Other names
Park Nicollet Clinic Episodic Bundle
Organization subpart
No
Provider details
NPI number
Authorized official
JASON JAMES LUHRS (VP FINANCE)
(952) 883-7158
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
10/25/2021
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