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NPI Code Detail

MEDICARE: DR. NATHAN WILLIAM KORANDA DNP

MEDICARE: DR. NATHAN WILLIAM KORANDA DNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner10393MN

General Provider Information

NPI Number : 1174200356
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN WILLIAM KORANDA DNP
Provider Business Mailing Address
First Line : 5123 W 98TH ST # 2110
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55437-2040
Country : US
Telephone Number : 630-854-6601
Fax Number :
Provider Business Practice Location Address
First Line : 700 RAYMOND AVE STE 130
Second Line :
City : SAINT PAUL
State : MN
Zip : 55114-1778
Country : US
Telephone Number : 612-699-7766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2023
Last Update Date : 10/28/2025

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