Individual
NICOLE ANNE BEMMELS CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.P.A.
Contact information
Practice address
6500 EXCELSIOR, PARK NICOLLET HEART AND VASCULAR CENTER, ST. LUOIS PARK, MN 55426
(612) 423-9088
Mailing address
6500 EXCELSIOR BLVD., PARK NICOLLET HEART AND VASCULAR CENTER, ST. LOUIS PARK, MN 55426
(612) 624-0123
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9899
MN
363AM0700X
Medical Physician Assistant
9899
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-06279
MEDICA PRIMARY
MN
01
—
01-19215
MEDICA CHOICE
MN
01
—
1042013
PREFERRED ONE
MN
01
—
132339
UCARE
MN
01
—
2230947
ARAZ
MN
05
—
41995800
—
WI
01
—
616R8BE
BCBS
MN
05
—
916427800
—
MN
01
—
B018
CHAMPUS/TRIWEST
MN
01
—
HP46702
HEALTHPARTNERS
MN
Enumeration date
06/16/2006
Last updated
01/26/2017
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