Provider Demographics
NPI:1033384813
Name:YOHN, NICOLE MARIE (ST (SURGICAL TECH))
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:YOHN
Suffix:
Gender:F
Credentials:ST (SURGICAL TECH)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W 140TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4480
Mailing Address - Country:US
Mailing Address - Phone:952-808-3000
Mailing Address - Fax:
Practice Address - Street 1:6465 WAYZATA BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-1728
Practice Address - Country:US
Practice Address - Phone:952-512-5637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist