Lande, Nicolle Michelle

Lande, Nicolle Michelle is an individual health care provider with primary practice located at 2550 University Avenue West Suite 229N, St Paul MN 55114. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Lande, Nicolle Michelle can be contacted via phone (651) 645-3115.

Contact Information

Primary practice address
2550 University Avenue West Suite 229N St Paul MN 55114
Phone: (651) 645-3115
Fax: (651) 645-2752
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9821 Minnesota

Profile Details

NPI number 1881671162
LBN Legal business name Lande, Nicolle Michelle
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881671162 NPPES
Minnesota MEDICAID 486965800
Minnesota Other 559K0LA

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