Healthcare Provider Details

I. General information

NPI: 1851202956
Provider Name (Legal Business Name): NATALIE MUDEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 W 3RD ST
DULUTH MN
55806-1706
US

IV. Provider business mailing address

3215 W 3RD ST
DULUTH MN
55806-1706
US

V. Phone/Fax

Practice location:
  • Phone: 218-336-8880
  • Fax:
Mailing address:
  • Phone: 218-336-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number2485243
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: