Individual
NICOLE MARIE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
237 RADIO DR STE 200, WOODBURY, MN 55125-4478
(612) 871-1145
Mailing address
1979 KNOB RD, MENDOTA HEIGHTS, MN 55118-4326
(612) 990-0674
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95577
OK
Other
Enumeration date
10/12/2009
Last updated
02/07/2024
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