Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 20150242 | MN |
NPI | 1023406121 |
---|---|
Provider Name | Noreen Elizabeth Nordling |
First Address | Randolph, MN 55065-9540 |
Second Address | Minneapolis, MN 55404-4518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2014 |
Last Update Date | 04/02/2015 |