Individual
DR. NANCY A. METTILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2855 CAMPUS DR, #350, PLYMOUTH, MN 55441-2649
(763) 520-1200
(763) 520-1201
Mailing address
2855 CAMPUS DR, #350, PLYMOUTH, MN 55441-2649
(763) 520-1200
(763) 520-1211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34644
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
959760300
—
MN
Enumeration date
03/07/2006
Last updated
09/22/2011
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