Individual
DR. NICOLE LYNN ROEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
560 S MAPLE ST STE 400, WACONIA, MN 55387-1757
(952) 442-2191
Mailing address
560 S MAPLE ST STE 400, WACONIA, MN 55387-1757
(603) 264-1335
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
63495
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2012
Last updated
11/26/2022
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