Organization
NORTHERN LIGHTS HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE M SIDDONS FNP-C (CO-FOUNDER)
(920) 217-9035
Entity
Organization
Contact information
Practice address
212 W LAKE ST, WACONIA, MN 55387-1014
(920) 217-9035
Mailing address
212 W LAKE ST, WACONIA, MN 55387-1014
(920) 217-9035
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/31/2019
Last updated
12/22/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up