Park Nicollet
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
9555 Upland Ln NMaple Grove, MN 66369
Phone: (952) 993-1589
No coordinates on file. Search this address in Google Maps
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 number | 1982150728 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Sofiya Tsukerman — Htcp · (763) 494-4686 |
| NPI enumerated | August 31, 2016 |
| Last updated in NPPES | August 31, 2016 |
| Mailing address | 7102 Olive Lane North, Maple Grove, MN 55311 |
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