Individual
VICKI LYNN NIEDZWIESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RN
Contact information
Practice address
3400 W 66TH ST, SUITE 290, EDINA, MN 55435-2111
(952) 914-1741
Mailing address
11067 OREGON CIR, BLOOMINGTON, MN 55438-2457
(651) 274-0381
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R129718-4
MN
Other
Enumeration date
06/10/2008
Last updated
09/06/2011
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