MEDICARE: COUNTY OF NICOLLET

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	251K00000X	Public Health or Welfare Agency
2	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083845127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF NICOLLET

Provider Business Mailing Address
First Line	:	622 S FRONT ST
Second Line	:
City	:	SAINT PETER
State	:	MN
Zip	:	56082-2106
Country	:	US
Telephone Number	:	507-934-8573
Fax Number	:	507-934-8552

Provider Business Practice Location Address
First Line	:	622 SO FRONT ST
Second Line	:
City	:	SAINT PETER
State	:	MN
Zip	:	56082-2557
Country	:	US
Telephone Number	:	507-934-8576
Fax Number	:	507-931-9562

Authorized Official
Title or Position	:	HEALTH AND HUMAN SERVICES DIRECTOR
Name	:	CASSANDRA ANNE SASSENBERG
Credential	:
Telephone Number	:	507-934-8573

Provider Enumeration Date	:	08/06/2009
Last Update Date	:	03/18/2021

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Directions to “COUNTY OF NICOLLET ” Practice Location

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