Individual
NICOLE RUBBELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
13782 BLUESTEM CT STE 100, BAXTER, MN 56425-8768
(218) 833-9107
Mailing address
13782 BLUESTEM CT STE 100, BAXTER, MN 56425-8768
(218) 833-9107
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
26091
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-3503652
—
MN
Enumeration date
02/21/2023
Last updated
02/21/2023
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