Healthcare Provider Details

I. General information

NPI: 1811341399
Provider Name (Legal Business Name): NIKKI L STOFFEL-LOWIS CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N JACKSON AVE
SPRINGFIELD MN
56087-1714
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 507-723-6201
  • Fax:
Mailing address:
  • Phone: 612-262-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number114
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: