Individual
NATHAN REYELTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1950 CENTER CREEK DR, SUITE 100, FAIRMONT, MN 56031-3428
(507) 238-4968
Mailing address
1950 CENTER CREEK DR, SUITE 100, FAIRMONT, MN 56031-3428
(507) 238-4968
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9910
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-18804
MEDICA
MN
05
—
131996
—
MN
05
—
151650700
—
MN
01
—
2229453
ARAZ
MN
01
—
320K0RE
BLUE CROSS
MN
05
—
320K0RE
—
MN
01
—
4686
AVERA
MN
05
—
959478
—
IA
01
—
HP47426
HEALTH PARTNERS
MN
01
—
MH9041041957
PREFERRED ONE
MN
Enumeration date
12/02/2005
Last updated
09/01/2020
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