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Individual

DR. NICOLE CHAISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2020 E 28TH ST., UFP SMILEY'S CLINIC, MINNEAPOLIS, MN 55407
(612) 333-0770
(612) 333-1986
Mailing address
2020 E 28TH ST., UMPHYSICIANS SMILEY'S CLINIC, MINNEAPOLIS, MN 55407
(612) 333-0770
(612) 333-1986

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44929
MN
207QA0000X
Adolescent Medicine (Family Medicine) Physician
44929
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-19354
MEDICA CHOICE & PRIMARY
MN
05
0586313
IA
01
1034699
PREFERRED ONE
MN
01
171902
UCARE
MN
01
2298998
ARAZ
MN
01
551T1CH
BCBS
MN
01
HP39171
HEALTHPARTNERS
MN
Enumeration date
06/26/2006
Last updated
02/07/2013
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