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Organization

TWO RIVERS LUNG SPECIALISTS, P. A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEANNE M NELSON M. D. (PRESIDENT/OWNER)
(763) 236-9494
Entity
Organization

Contact information

Practice address
4040 COON RAPIDS BLVD NW, SUITE #100, COON RAPIDS, MN 55433-2522
(763) 236-9494
(763) 236-9495
Mailing address
4040 COON RAPIDS BLVD NW, SUITE #100, COON RAPIDS, MN 55433-2522
(763) 236-9494
(763) 236-9495

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
1564
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001
MEDICA
MN
01
142464
UCARE
MN
01
193J9TW
BCBS OF MN
MN
05
788700100
MN
01
83654
HEALTH PART
MN
01
CJ7024
RAILROAD MEDICARE
MN
Enumeration date
07/09/2006
Last updated
01/26/2010
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