Healthcare Provider Details

I. General information

NPI: 1235059544
Provider Name (Legal Business Name): NASRA GELLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MARIE AVE E STE 202
WEST ST PAUL MN
55118-5950
US

IV. Provider business mailing address

7475 FLYING CLOUD DR APT 461
EDEN PRAIRIE MN
55344-3838
US

V. Phone/Fax

Practice location:
  • Phone: 651-315-2321
  • Fax:
Mailing address:
  • Phone: 612-245-0686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: