Affiliated Community Medical Centers, PA
Organization Active NPI Family Nurse Practitioner · Wilmlar, MN
NPI 1962899302 · NPPES record last updated Apr 23, 2015
Key facts
- NPI
- 1962899302
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- CNP3732 (MN)
- Legal business name
- AFFILIATED COMMUNITY MEDICAL CENTERS, PA
- Practice address
- 101 Willmar Ave SW
Wilmlar, MN 56201-3591 - Phone
- (320) 231-5079
- Fax
- (320) 231-5067
- NPI assigned
- Apr 23, 2015
- Organization subpart
- No
Authorized official
- Name
- Ronald L Holmgren, MD
- Title
- President
- Phone
- (320) 231-5079
National Provider Directory
Locations
101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | CNP3732 | MN | Yes |
Addresses
Primary practice location
101 Willmar Ave SW
Wilmlar, MN 56201-3591
Mailing address
101 Willmar Ave SW
Wilmlar, MN 56201-3591
Phone (320) 231-5079
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.