MR. RICK LEE NISSEN


Address: 8714 Lyndale Ave S, Minneapolis, MN 55420-2738
Phone: 9529489695

MR. RICK LEE NISSEN (NPI# 1306842711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306842711
Entity Type Individual
Full Name MR. RICK LEE NISSEN
Credential M.D.
Practice Address 8714 Lyndale Ave S
Minneapolis
MN 55420-2738
Practice Telephone 9529489695
Practice Fax Number 9529489086
Mailing Telephone 9529489695
Mailing Fax Number 9529489086
Enumeration Date 2005-06-22
Last Update Date 2013-02-25
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207YS0123X Otolaryngology
Specialization: Facial Plastic Surgery
30501 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MN 397082500 05

Office Location

Street Address 8714 LYNDALE AVE S
City MINNEAPOLIS
State MN
Zip Code 55420-2738

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1629223722 Jennifer Jean Bormann Audiologist 8714 Lyndale Avenue South, Minneapolis, MN 55420 2008-11-18
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Find all providers in zip 55420

Taxonomy Information

Taxonomy Code 207YS0123X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology
Specialization Facial Plastic Surgery

Taxonomy Definition

An otolaryngologist who specializes in facial plastic surgery.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1891089850 Nathan Daniel Johnson Otolaryngology 2211 Park Ave, Minneapolis, MN 55404-3711 2011-06-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1427493485 Ronald J Schroeder II Otolaryngology 2080 Woodwinds Dr Ste 220, Woodbury, MN 55125-2529 2013-05-05
1851518674 Edward Henry Szachowicz Otolaryngology 7373 France Av. So., Suite #508, Edina, MN 55435-4549 2007-04-20
1669897500 Casey Fisher Otolaryngology 3366 Oakdale Ave N Ste 150, Robbinsdale, MN 55422-2978 2014-03-02
1316212632 Brett James Baldwin Otolaryngology 1421 Premier Dr, Mankato, MN 56001-6076 2012-03-20
1265583652 Kurtis A. Waters, M.d., P.a. Otolaryngology 13359 Isle Dr, Suite 1, Baxter, MN 56425-2221 2007-01-15
1043256357 Christopher John Tolan Otolaryngology 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2006-06-22
1194775429 Michael D Peters Otolaryngology 9825 Hospital Dr, Suite Ll-10, Maple Grove, MN 55369-4479 2006-05-10

Competitor

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City MINNEAPOLIS
Zip Code 55420

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Dataset Information

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.

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