Northern Lights Pediatric & Adolescent Medicine
LBN: Northern Lights Pediatric & Adolescent Medicine
Northern Lights Pediatric & Adolescent Medicine is an health care organization with primary practice located at 3555 Willow Lake Blvd. Suite 140, Vadnais Heights MN 55110-4462. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty.
Northern Lights Pediatric & Adolescent Medicine can be contacted via phone (651) 251-5280, or through Mccabe, Wendy Marian Nelms via phone (651) 251-5280.
Contact Information
Primary practice address
3555 Willow Lake Blvd. Suite 140
Vadnais Heights MN 55110-4462
Phone: (651) 251-5280
Fax: (651) 251-5282
Website:
Authorized official contact:
Name: Mccabe, Wendy Marian Nelms Doctor of Medicine (MD)
Phone: (651) 251-5280
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X |
Profile Details
| NPI number | 1912069519 |
|---|---|
| LBN Legal business name | Northern Lights Pediatric & Adolescent Medicine |
| DBA Doing business as | |
| Authorized official | Mccabe, Wendy Marian Nelms Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 14th, 2006 |
| Last updated | May 20th, 2009 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912069519 | NPPES |
| Minnesota | Other | 29960NO | BCBS MN |
| Minnesota | MEDICAID | 744432000 | BCBS MN |
| Minnesota | Other | 165339 | BCBS MN |
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