Healthcare Provider Details
I. General information
NPI: 1750316014
Provider Name (Legal Business Name): NURA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/12/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2104 NORTHDALE BOULEVARD NW SUITE 220
MINNEAPOLIS MN
55433
US
IV. Provider business mailing address
2104 NORTHDALE BLVD NW STE 220
COON RAPIDS MN
55433-3046
US
V. Phone/Fax
- Phone: 763-537-6000
- Fax: 763-537-6666
- Phone: 763-537-6000
- Fax: 763-537-6666
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SANDFORD
MATTHEW
SCHOCKET
Title or Position: CEO
Credential: MD
Phone: 763-537-6000