Healthcare Provider Details

I. General information

NPI: 1639348477
Provider Name (Legal Business Name): NOELLE ELIZABETH BACH HALLOIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 CURVE CREST BLVD W
STILLWATER MN
55082-5085
US

IV. Provider business mailing address

2900 CURVE CREST BLVD
STILLWATER MN
55082
US

V. Phone/Fax

Practice location:
  • Phone: 855-324-7843
  • Fax:
Mailing address:
  • Phone: 651-471-5600
  • Fax: 507-345-1319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD036922
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: