Healthcare Provider Details

I. General information

NPI: 1891606877
Provider Name (Legal Business Name): NICOLE DAHLGREN RN
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

1 VETERANS DR
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

2483 154TH LN NW
ANDOVER MN
55304-2777
US

V. Phone/Fax

Practice location:
  • Phone: 612-725-5000
  • Fax:
Mailing address:
  • Phone: 612-670-8644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number2289939
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: