Individual
NICOLE TE POEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(952) 967-7977
Mailing address
PO BOX 1309, MAIL STOP 21110Q, MINNEAPOLIS, MN 55440-1309
(651) 254-3456
(651) 254-9673
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
66589-20
WI
207Q00000X
Family Medicine Physician
Primary
60354
MN
207Q00000X
Family Medicine Physician
MD19823
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2010
Last updated
05/10/2019
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