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Individual

EVELYN F NIETFELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CNP

Contact information

Practice address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369
(763) 201-8191
(763) 201-8192
Mailing address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369-4466
(763) 201-8191
(763) 201-8192

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP306
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0113787
MEDICA
MN
01
943041034607
PREFERRED ONE INSURANCE
MN
Enumeration date
09/27/2006
Last updated
06/13/2018
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