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

Park Nicollet Clinic

Organization Family Medicine Physician · NPI 1780621904

Park Nicollet Clinic is a Family Medicine Physician in St Louis Park, Minnesota. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
4

Practice location Address checks out

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone: (952) 993-3123
Fax: (952) 993-2770
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Pediatrics Physician Taxonomy 208000000X
Urgent Care Clinic/Center Taxonomy 261QU0200X

Record details

NPI number1780621904
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alita Risinger — Sr Vice President, Cfo · (952) 883-5401
NPI enumeratedMay 31, 2006
Last updated in NPPESAugust 3, 2026
Certification dateAugust 3, 2026
Mailing address3800 Park Nicollet Blvd, Att Business Services, St Louis Park, MN 55416

Other providers in St Louis Park