MEDICARE: HEIDI D NELSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	14095	MN

General Provider Information

NPI Number	:	1194696773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI D NELSON

Provider Business Mailing Address
First Line	:	2925 CHICAGO AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1321
Country	:	US
Telephone Number	:	612-262-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 E 28TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-3723
Country	:	US
Telephone Number	:	612-863-6029
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2025
Last Update Date	:	04/21/2026

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Directions to “ HEIDI D NELSON ” Practice Location

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