Healthcare Provider Details

I. General information

NPI: 1932019312
Provider Name (Legal Business Name): JULIE NIELSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

IV. Provider business mailing address

2317 STINSON BOULEVARD NORTHEAST
MINNEAPOLIS MN
55418
US

V. Phone/Fax

Practice location:
  • Phone: 651-210-7260
  • Fax:
Mailing address:
  • Phone: 651-210-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number170007-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: