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General NPI Number Information
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NPI Number | 1528494564
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Entity Type | Individual
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Provider Name | DR. NELI AUGUSTSON
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Gender | Female
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Dates
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Enumeration Date | 09/23/2013
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 8360 CITY CENTRE DR STE 112
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City | WOODBURY
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State | MN
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Zip | 55125-5362
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Country | US
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Telephone | 651-315-7419
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Fax | 651-382-0018
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Provider Business Mailing Address
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Address Line | 9001 HIGHVIEW LN
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City | WOODBURY
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State | MN
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Zip | 55125-4921
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Country | US
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Telephone | 612-532-8925
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 64217
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License Number State | MN
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