MEDICARE: NICOLE LAMPI SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7301	MN

General Provider Information

NPI Number	:	1083615314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE LAMPI SLP

Provider Business Mailing Address
First Line	:	6997 POLARIS LN N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-3219
Country	:	US
Telephone Number	:	763-420-6909
Fax Number	:

Provider Business Practice Location Address
First Line	:	9220 BASS LAKE RD
Second Line	:	SUITE 260
City	:	NEW HOPE
State	:	MN
Zip	:	55428-3000
Country	:	US
Telephone Number	:	763-533-0363
Fax Number	:	763-533-0842

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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Directions to “ NICOLE LAMPI SLP” Practice Location

Language	Start Address	Practice Location

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