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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
30501 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | 397082500 | 05 |
Street Address |
8714 LYNDALE AVE S |
City | MINNEAPOLIS |
State | MN |
Zip Code | 55420-2738 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457986556 | Jon Brookson Engfer | Counselor | 8609 Lyndale Avenue South, Bloomington, MN 55420 | 2020-03-09 |
1720624810 | Sunshine Assisted Living Services LLC | Home Health | 9540 Columbus Ave S, Bloomington, MN 55420 | 2019-11-23 |
1417205246 | Jrb Holdings, LLC | Home Health | 9897 Lyndale Ave S, Bloomington, MN 55420 | 2012-08-28 |
1629223722 | Jennifer Jean Bormann | Audiologist | 8714 Lyndale Avenue South, Minneapolis, MN 55420 | 2008-11-18 |
1801055959 | Sarah J. Marsden | Speech-Language Pathologist | 900 W 94th St., Bloomington, MN 55420 | 2008-06-04 |
1699949784 | 1st Choice Care, Inc. | Home Health | 9035 Blaisdell Ave S, Bloomington, MN 55420 | 2008-04-18 |
1922295203 | Cornerstone Advocacy Service | Community/Behavioral Health | 1000 East 80th St, Bloomington, MN 55420 | 2007-10-01 |
1184769457 | Fairview Oxboro Pharmacy Mtm | Non-Pharmacy Dispensing Site | 600 W 98th Street, Bloomington, MN 55420 | 2007-02-21 |
1891831723 | A Caring Company, Inc. | In Home Supportive Care | 9001 East Bloomington Freeway, Sutie 145, Bloomington, MN 55420 | 2007-01-29 |
1134279318 | Jennifer Mary Connelly | Speech-Language Pathologist | 9001 E Bloomington Fwy Ste 141, Bloomington, MN 55420 | 2007-01-11 |
Find all providers in zip 55420 |
Taxonomy Code | 207YS0123X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
Specialization | Facial Plastic Surgery |
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. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891089850 | Nathan Daniel Johnson | Otolaryngology | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2011-06-07 |
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 |
City | MINNEAPOLIS |
Zip Code | 55420 |
Please comment or provide details below to improve the information on MR. RICK LEE NISSEN.
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.