Healthcare Provider Details

I. General information

NPI: 1134090228
Provider Name (Legal Business Name): KARIN NOWICKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2025
Last Update Date: 09/13/2025
Certification Date: 09/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7413 ELM LN
HAMEL MN
55340-1102
US

IV. Provider business mailing address

7413 ELM LN
HAMEL MN
55340-1102
US

V. Phone/Fax

Practice location:
  • Phone: 612-701-6748
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2408396
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: