Individual
NICOLIS BAUMGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, PHN
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(952) 467-3514
(952) 467-3514
Mailing address
13725 VERNON CIR, SAVAGE, MN 55378-1893
(952) 463-6174
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R2448631
MN
Other
Enumeration date
08/16/2017
Last updated
08/16/2017
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