Organization
MINNESOTA NEUROSURGICAL TRAUMA ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE S NELSON M.D. (CEO)
(763) 427-1137
Entity
Organization
Contact information
Practice address
11850 BLACKFOOT ST NW, SUITE 490, COON RAPIDS, MN 55433-2578
(763) 427-1137
(763) 427-4643
Mailing address
11850 BLACKFOOT ST NW, SUITE 490, COON RAPIDS, MN 55433-2578
(763) 427-1137
(763) 427-4643
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Enumeration date
04/08/2009
Last updated
04/25/2024
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