Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | D8566 | MN |
Y | 213EG0000X | General Practice | D8566 | MN |
NPI | 1003820564 |
---|---|
Provider Name | Dr. Ned Albert Nippoldt |
First Address | Woodbury, MN 55125 |
Second Address | Woodbury, MN 55125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |