Provider Demographics
NPI:1073071239
Name:NICE HEALTHCARE LLC
Entity Type:Organization
Organization Name:NICE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMPSON
Authorized Official - Middle Name:TEMILADE
Authorized Official - Last Name:ADERINKOMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-334-0720
Mailing Address - Street 1:721 QUINCY ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-2317
Mailing Address - Country:US
Mailing Address - Phone:651-334-0720
Mailing Address - Fax:
Practice Address - Street 1:721 QUINCY ST NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-2317
Practice Address - Country:US
Practice Address - Phone:651-334-0720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty