Nicoloff, Martha H

Nicoloff, Martha H is an individual health care provider with primary practice located at 8100 34Th Ave S Mc21110Q, Bloomington MN 55425-1672. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Nicoloff, Martha H can be contacted via phone (952) 883-6805.

Contact Information

Primary practice address
8100 34Th Ave S Mc21110Q Bloomington MN 55425-1672
Phone: (952) 883-6805
Fax: (952) 883-6117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1274796 Minnesota

Profile Details

NPI number 1629044599
LBN Legal business name Nicoloff, Martha H
Credentials Gerontological Nurse Practitioner (GNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Nov 17th, 2008 - about 16 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 1629044599 NPPES
Minnesota MEDICAID 670097700

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