Individual
DR. LORI ANN NIDEVER NIDERSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
(763) 581-3982
Mailing address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447-4835
(763) 559-3779
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
47739
MN
Other
Enumeration date
08/16/2007
Last updated
10/04/2016
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