Healthcare Provider Details

I. General information

NPI: 1619021110
Provider Name (Legal Business Name): AMY E NYGAARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY ELIZABETH NYGAARD MD

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 GOLDEN VALLEY RD STE 300
MINNEAPOLIS MN
55427-4484
US

IV. Provider business mailing address

8301 GOLDEN VALLEY RD STE 300
MINNEAPOLIS MN
55427-4484
US

V. Phone/Fax

Practice location:
  • Phone: 763-312-6772
  • Fax: 224-432-6674
Mailing address:
  • Phone: 763-312-6772
  • Fax: 224-432-6674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number47250
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: