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NPI Code Detail

MEDICARE: NICOLE KATHRYN ZLEBEK NP

MEDICARE: NICOLE KATHRYN ZLEBEK NP
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
1363L00000XNurse Practitioner7520MN

General Provider Information

NPI Number : 1619579729
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE KATHRYN ZLEBEK NP
Provider Business Mailing Address
First Line : 5245 EWING AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55410-2010
Country : US
Telephone Number : 224-563-7527
Fax Number :
Provider Business Practice Location Address
First Line : 2220 PLYMOUTH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-3600
Country : US
Telephone Number : 224-563-7527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2020
Last Update Date : 03/20/2025

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