Northern Lights Pediatric & Adolescent Medicine
Pediatric Adolescent Medicine
Northern Lights Pediatric & Adolescent Medicine is a Vadnais Heights, Minnesota based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
3555 Willow Lake Blvd., Suite 140, Vadnais Heights, Minnesota - 55110-4462. They can be contacted on phone at
651-251-5280 and fax number 651-251-5282.
NPI number (Unique professional ID) for Northern Lights Pediatric & Adolescent Medicine is
1912069519 which was assigned by NPPES on 14 Dec, 2006 and it was last updated on 20 May, 2009.
Northern Lights Pediatric & Adolescent Medicine specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Northern Lights Pediatric & Adolescent Medicine basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Northern Lights Pediatric & Adolescent Medicine |
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Business Address:
Northern Lights Pediatric & Adolescent Medicine address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 3555 Willow Lake Blvd., Suite 140
Vadnais Heights, MN, 55110-4462
United States |
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| Phone Number : | 651-251-5280 |
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| Fax Number : | 651-251-5282 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1912069519 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 14 Dec, 2006 |
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| Last Updated On : | 20 May, 2009 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Wendymarian Nelms Mccabe |
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| Authorized Official Credential : | M.D. |
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| Official Title or Position : | PARTNER |
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| Phone Number : | 651-251-5280 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Northern Lights Pediatric & Adolescent Medicine are as mentioned. Primary taxonomy code for Northern Lights Pediatric & Adolescent Medicine is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Northern Lights Pediatric & Adolescent Medicine such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 29960NO | Other | MN | BCBS MN |
| 744432000 | MEDICAID | MN | |
| 165339 | Other | MN | UCARE |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 3555 Willow Lake Blvd., Suite 140
Vadnais Heights, MN, 55110-4462
United States |
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| Phone Number : | 651-251-5280 |
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| Fax Number : | 651-251-5282 |
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Business Location:
Patients can refer following map for directions to
Northern Lights Pediatric & Adolescent Medicine practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.