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Individual

SANDRA L IVERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
NORTH METRO PEDIATRICS 10081 DOGWOOD STREET NW, SUITE 100, COON RAPIDS, MN 55448
(763) 783-3722
(763) 783-7944
Mailing address
NORTH METRO PEDIATRICS 10081 DOGWOOD STREET NW, SUITE 100, COON RAPIDS, MN 55448
(763) 783-3722
(763) 783-7944

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R 063381-7
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
025A2IV
BCBS
MN
01
1043948
PREFERRED ONE
01
104736
U CARE
MN
01
12-00987
MEDICA-CHOICE
01
12-09026
MEDICA-PRIMARY
01
1576851
AMERICAS PPO/ARAZ
01
207209
FAIRVIEW
MN
05
4305613
MT
05
43929100
WI
05
941742700
MN
01
A520
CHAMPUS
01
HP21983
HEALTH PARTNERS
MN
01
P00014192
RAILROAD MEDICARE
Enumeration date
09/26/2006
Last updated
10/03/2012
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