Graduated: 2016
NPI: 1285086074
Practice Locations (3)
PARK NICOLLET CLINIC
5320 HYLAND GREENS DR
BLOOMINGTON, MN 554373934
9529932400
PARK NICOLLET CLINIC
15800 95TH AVE N
MAPLE GROVE, MN 553694400
9529931440
PARK NICOLLET CLINIC
4155 COUNTY RD 101
PLYMOUTH, MN 554462307
9529938900
Source: CMS National Downloadable File, September 2026.