Healthcare Provider Details

I. General information

NPI: 1972510220
Provider Name (Legal Business Name): MEE LEE CHUN NELSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E NICOLLET BLVD SYE 200
BURNSVILLE MN
55337-6732
US

IV. Provider business mailing address

3955 PARKLAWN AVENUE SUITE 120 SOUTHDALE PEDIATRIC ASSOCIATES LTD.
EDINA MN
55435-5660
US

V. Phone/Fax

Practice location:
  • Phone: 952-898-5900
  • Fax:
Mailing address:
  • Phone: 952-831-4454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number43287
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: