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General NPI Number Information
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NPI Number | 1700745650
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Entity Type | Organization
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Legal Business Name | MEWINZHA ENDAADIZIIKE WIIGAMING
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 802 PAUL BUNYAN DR S STE 12
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City | BEMIDJI
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State | MN
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Zip | 56601-3204
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Country | US
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Telephone | 218-444-4323
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Fax |
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Provider Business Mailing Address
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Address Line | 802 PAUL BUNYAN DR S STE 12
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City | BEMIDJI
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State | MN
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Zip | 56601-3204
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Country | US
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Telephone | 218-444-4323
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | NATALIE NICKOLSON
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Credential | APRN-CNP
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Telephone | 218-444-4243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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