Alice Ethel Nordlum

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

304361 Issued in MN

Practice address

5842 Old Main St Ste 2
North Branch, MN 55056-6687

Phone

(651) 401-3068

Fax

(651) 674-2534

NPI assigned

Mar 4, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520121600000",
    "number": "1891297024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 N RYAN LAKE RD NE",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "550406146",
            "telephone_number": "763-607-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5842 OLD MAIN ST STE 2",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566687",
            "telephone_number": "651-401-3068",
            "fax_number": "651-674-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDLUM",
        "first_name": "ALICE",
        "middle_name": "ETHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-04",
        "last_updated": "2018-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarrod Allen Nelson, O.D.
• Michelle M Nelson, MSN, FNP-BC
• Nesting Space Therapy PLLC
• Neve Inc
• Kristi Lynn Newton
• North Branch Family Chiropractic LLC
• North Branch Isd 138
• Northstone Family Chiropractic P.a.
• Jeremiah Nyamache
• Janice Larayne Olson, LPC

• Addiction (Substance Use Disorder) Counselor in North Branch, MN
• Providers in North Branch, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.