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1881683696

NPI Code Detail

MEDICARE: BRIAN DEANE NELSON MD

MEDICARE: BRIAN DEANE NELSON MD

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	207R00000X	Internal Medicine Physician	40084	MN
2	208M00000X	Hospitalist Physician	40084	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00174824	OTHER		RR MEDICARE
10	C11369	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6D053CE	OTHER		BLUE CROSS BLUE SHIELD
2	313K7NE	OTHER		BLUE CROSS BLUE SHIELD
3	106868	OTHER		U-CARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1033658	OTHER		ARAZ GROUP/AMERICA'S PPO
7	0407013	OTHER		MEDICA HEALTH PLANS
8	1012483	OTHER		PREFERRED ONE
9	400219900	OTHER		MEDICAL ASSISTANCE
11	HP20578	OTHER		HEALTH PARTNERS

General Provider Information

NPI Number	:	1881683696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN DEANE NELSON MD

Provider Business Mailing Address
First Line	:	1200 SIXTH AVE N
Second Line	:
City	:	ST CLOUD
State	:	MN
Zip	:	56303-2735
Country	:	US
Telephone Number	:	320-251-2700
Fax Number	:	320-240-2118

Provider Business Practice Location Address
First Line	:	6401 FRANCE AVE S
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-2104
Country	:	US
Telephone Number	:	952-924-5000
Fax Number	:

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

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	11/28/2023

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Directions to “ BRIAN DEANE NELSON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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