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NPI Code Detail

MEDICARE: NAN TURNER MACDONALD MS, LP

MEDICARE: NAN TURNER MACDONALD MS, LP
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
1103T00000XPsychologistLP2978MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11821198391OTHERMNNPI

General Provider Information

NPI Number : 1821198391
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAN TURNER MACDONALD MS, LP
Provider Business Mailing Address
First Line : 3333 UNIVERSITY AVE SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-3325
Country : US
Telephone Number : 612-331-9413
Fax Number : 612-728-5301
Provider Business Practice Location Address
First Line : 3333 UNIVERSITY AVE SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-3325
Country : US
Telephone Number : 612-331-9413
Fax Number : 612-728-5301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 10/13/2022

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