Healthcare Provider Details

I. General information

NPI: 1922389790
Provider Name (Legal Business Name): YUKIKO NAKAJIMA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 RIVERSIDE AVE
MINNEAPOLIS MN
55454-1450
US

IV. Provider business mailing address

445 ETNA ST STE 55
SAINT PAUL MN
55106-5848
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-8700
  • Fax: 612-273-8787
Mailing address:
  • Phone: 651-254-9447
  • Fax: 651-254-9238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP1108
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1108
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: