Individual
NOELLE M NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8100 W 78TH ST # ST100, EDINA, MN 55439-2516
(952) 914-8100
(952) 914-8101
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
41692
MN
208000000X
Pediatrics Physician
Primary
64916
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
629628900
—
MN
Enumeration date
12/12/2006
Last updated
11/10/2020
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