Individual
NICOLE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
32405 NORTHSHIRE CT, LINDSTROM, MN 55045-9089
(651) 734-8121
Mailing address
32405 NORTHSHIRE CT, LINDSTROM, MN 55045-9089
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
124990
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124990
LICENSE
MN
Enumeration date
02/09/2023
Last updated
02/09/2023
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