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

Park Nicollet

Organization Clinic/Center · NPI 1982150728

Park Nicollet is a Clinic/Center in Maple Grove, Minnesota. Licensed in Minnesota. Registered with an NPI since 2016.

Licensed in
MN
In the registry since
2016
Specialties on file
2

Practice location Address may be wrong

The ZIP code does not match the city and state on this record. Call before visiting.

9555 Upland Ln N
Maple Grove, MN 66369
Phone: (952) 993-1589

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X · Licence L 48617-4 (MN)
Ambulatory Surgical Clinic/Center Taxonomy 261QA1903X · Licence L 48617-4 (MN)

Record details

NPI number1982150728
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sofiya Tsukerman — Htcp · (763) 494-4686
NPI enumeratedAugust 31, 2016
Last updated in NPPESAugust 31, 2016
Mailing address7102 Olive Lane North, Maple Grove, MN 55311

Other providers in Maple Grove