Individual
NICOLE LEA WENTWORTH HARTUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 273-8383
Mailing address
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
43587
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1027664
PREFERRED ONE
MN
01
—
1383614
AMERICA'S PPO
MN
01
—
140263
UCARE MN
MN
05
—
260472800
—
MN
05
—
34182800
—
WI
01
—
3600166
MEDICA
MN
01
—
69B77WE
BLUE CROSS BLUE SHIELD MN
MN
01
—
HP33218
HEALTHPARTNERS
MN
Enumeration date
03/16/2006
Last updated
07/12/2024
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