Individual
SUSAN K NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5500 BOONE AVE N, NEW HOPE, MN 55428-3629
(701) 793-4444
Mailing address
40016 EDISON DR NE, STANCHFIELD, MN 55080-3232
(701) 793-4444
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39672
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174617732
—
MN
Enumeration date
10/03/2006
Last updated
07/16/2024
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