Active NPI
Nicole E Nelson, PHARMD, BCPS
- Pharmacist
- Fridley, MN
National Provider Identifier
1669619318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 118291
- Practice address
- 550 Osborne Rd NE
Fridley, MN 55432-2718 - Phone
- (763) 236-4123
- NPI assigned
- Jan 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 118291 | MN | Primary |
Addresses
Primary practice location
550 Osborne Rd NE
Fridley, MN 55432-2718
Mailing address
1283 129TH Ave NW
Coon Rapids, MN 55448-4016
Phone (651) 334-3292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118291 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232150400000",
"number": "1669619318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1283 129TH AVE NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554484016",
"telephone_number": "651-334-3292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 OSBORNE RD NE",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554322718",
"telephone_number": "763-236-4123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "NICOLE",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PHARMD, BCPS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-17",
"last_updated": "2009-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "118291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fridley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.