Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pain Specialist of Minnesota

Organization Family Nurse Practitioner · NPI 1508562240

Pain Specialist of Minnesota is a Family Nurse Practitioner in St Louis Park, Minnesota. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

5810 Excelsior Blvd
St Louis Park, MN 55416-2830
Phone: (612) 235-6008
Fax: (612) 235-6003
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1508562240
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Stock — Ceo · (651) 238-8580
NPI enumeratedFebruary 3, 2023
Last updated in NPPESJanuary 22, 2025
Certification dateJanuary 22, 2025
Mailing address5810 Excelsior Blvd, St Louis Park, MN 55416-2830

Other providers in St Louis Park