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NPI Code Detail

MEDICARE: LINDA MAXINE NIELSON R.N.

MEDICARE: LINDA MAXINE NIELSON R.N.
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
1323P00000XPsychiatric Residential Treatment FacilityR 1080210MN

General Provider Information

NPI Number : 1619375235
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA MAXINE NIELSON R.N.
Provider Business Mailing Address
First Line : 1593 HEWITT AVE
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-1221
Country : US
Telephone Number : 651-645-9424
Fax Number : 651-645-3216
Provider Business Practice Location Address
First Line : 1593 HEWITT AVE
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-1221
Country : US
Telephone Number : 651-645-9424
Fax Number : 651-645-3216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2014
Last Update Date : 12/13/2014

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Directions to “ LINDA MAXINE NIELSON R.N.” Practice Location

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