Mettille, Nancy A.

Mettille, Nancy A. is an individual health care provider with primary practice located at 2855 Campus Dr #350, Plymouth MN 55441-2649. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mettille, Nancy A. can be contacted via phone (763) 520-1200.

Contact Information

Primary practice address
2855 Campus Dr #350 Plymouth MN 55441-2649
Fax: (763) 520-1201
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 34644 Minnesota

Profile Details

NPI number 1407823560
LBN Legal business name Mettille, Nancy A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2006
Last updated Sep 22nd, 2011 - about 13 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 1407823560 NPPES
Minnesota MEDICAID 959760300

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