NICOLE PALM (NPI# 1104008093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104008093 |
Entity Type | Individual |
Full Name | NICOLE PALM |
Credential | PAC |
Practice Address |
4729 County Road 101 Minnetonka MN 55345-2634 |
Practice Telephone | 9529743200 |
Practice Fax Number | 9529743201 |
Mailing Telephone | 9529743200 |
Mailing Fax Number | 9529743201 |
Enumeration Date | 2007-12-03 |
Last Update Date | 2007-12-03 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1081 | MN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | MN REGISTRATION | 1081 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790191849 | Nicole Palm | Pharmacist | 1401 Slate Ct, Cleveland Heights, OH 44118-1417 | 2014-07-09 |
1497168330 | Nicole Floyd Palm | Internal Medicine | 7800 Lake Underhill Rd, Orlando Medical Centers, Orlando, FL 32822 | 2014-06-09 |
Street Address |
4729 COUNTY ROAD 101 |
City | MINNETONKA |
State | MN |
Zip Code | 55345-2634 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750332649 | Mark Edward Stevenson | Family Medicine | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2006-05-15 |
1528554409 | Jeremy Eugene Miller | Massage Therapist | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2018-07-03 |
1144636838 | Allie Rae Nowak | Physician Assistant | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2014-07-02 |
1497160246 | Katarina Ruth Astrup | Physician Assistant | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2014-06-30 |
1053737619 | Allina Health System | Clinic/Center | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2014-03-06 |
1730436288 | Emily Knaeble | Physician Assistant | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2012-08-14 |
1942530464 | John Alan Hitt | Internal Medicine | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2010-01-05 |
1568600484 | Vikisha A Goberdhan | Physician Assistant | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2009-01-30 |
1033354832 | Teresa P Angier | Physician Assistant | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2008-12-08 |
1801057559 | Angela A Moreira | Physician Assistant | 4729 County Road 101, Minnetonka, MN 55345-2634 | 2008-06-24 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417587205 | Pain Partners LLC | Pharmacist | 15225 Wild Wings Court, Minnetonka, MN 55345 | 2020-01-21 |
1356811608 | Caitlin Marie Peterson | Specialist/Technologist | 15708 Wood Knoll Lane, Minnetonka, MN 55345 | 2018-11-29 |
1649747007 | West Side Counseling LLC | Community/Behavioral Health | 10520 Wayzata Blvd., Suite 100, Minnetonka, MN 55345 | 2018-10-24 |
1689173247 | Theresa Tsuchiya | Psychologist | Relate, Inc., 5125 County Road 101, Suite 300, Minnetonka, MN 55345 | 2018-02-08 |
1497264147 | Minnetonka Assisted Living and Hospice | Community Health Worker | 14667 Lake Street Extension, Minnetonka, MN 55345 | 2017-09-26 |
1619494671 | Shree Revenue Management | Durable Medical Equipment & Medical Supplies | 6117, Creek Ridge Ct, Minnetonka, MN 55345 | 2017-08-29 |
1538606876 | Stefani Yanizeski | Speech-Language Pathologist | Minnesota Autism Center, 5710 Baker Road, Minnetonka, MN 55345 | 2017-01-25 |
1790157469 | Greg Anderson | Psychologist | 5125 County Road 101, #300, Relate, Inc., Minnetonka, MN 55345 | 2015-10-21 |
1861896375 | Kristine L Smith | Marriage & Family Therapist | 5125 County Road 101 Suite 300, Minnetonka, MN 55345 | 2014-10-13 |
1982014460 | Miranda Jean Johnson | Speech-Language Pathologist | 15265 Minnetonka Blvd., Minnetonka, MN 55345 | 2014-05-06 |
Find all providers in zip 55345 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306383609 | Kathryn Gestach | Physician Assistant | 14001 Ridgedale Dr, Suite 100, Minnetonka, MN 55305-1753 | 2017-01-24 |
1598099418 | Andrew Gilbert | Physician Assistant | 2000 Plymouth Rd, Minnetonka, MN 55305-2366 | 2009-09-24 |
1306079652 | Luke Hammer | Physician Assistant | 2000 Plymouth Rd, Minnetonka, MN 55305-2366 | 2009-09-02 |
1326203258 | Amy Keding | Physician Assistant | 2000 Plymouth Rd, Minnetonka, MN 55305-2366 | 2008-07-21 |
1720248172 | Jennifer Kupper | Physician Assistant | 2000 Plymouth Rd, Minnetonka, MN 55305-2366 | 2008-06-10 |
1336297043 | Eric Harl | Physician Assistant | 2000 Plymouth Rd Ste 100, Minnetonka, MN 55305-2334 | 2007-01-08 |
1750368262 | James M Bahrke | Physician Assistant | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5201 | 2005-12-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255969150 | Isaac Waalen | Physician Assistant | 5420 Circle Down, Minneapolis, MN 55416-1312 | 2020-03-28 |
1730643701 | Christina Jones | Physician Assistant | 11850 Blackfoot St Nw Ste 270, Coon Rapids, MN 55433-2593 | 2019-01-24 |
1114492964 | Molly Goss | Physician Assistant | 1817 Sunset Dr, Northfield, MN 55057-3246 | 2018-10-09 |
1932600160 | Ellen Kathryn Freeman | Physician Assistant | 111 Hundertmark Rd Ste 480, Chaska, MN 55318-1485 | 2018-02-22 |
1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
1538545686 | Kathryn Jelle | Physician Assistant | 3931 Louisiana Ave S # 55426, St Louis Park, MN 55426-5000 | 2015-07-30 |
1831503267 | Karrah Oliver | Physician Assistant | 205 Roosevelt Ave W, Karlstad, MN 56732-4022 | 2014-06-13 |
1477981777 | Melissa Ferraz De Toledo | Physician Assistant | 9145 Springbrook Dr Nw Ste 300, Coon Rapids, MN 55433-5897 | 2013-10-23 |
Find all providers with the same taxonomy |
City | MINNETONKA |
Zip Code | 55345 |
Please comment or provide details below to improve the information on NICOLE PALM.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.