Provider Demographics
NPI:1437624608
Name:TOUSSAINT, NELSIE
Entity Type:Individual
Prefix:
First Name:NELSIE
Middle Name:
Last Name:TOUSSAINT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 HIGHWAY 100 S APT 102
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1733
Mailing Address - Country:US
Mailing Address - Phone:651-398-6849
Mailing Address - Fax:
Practice Address - Street 1:10584 FRANCE AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-3538
Practice Address - Country:US
Practice Address - Phone:952-666-6000
Practice Address - Fax:952-209-1583
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6129363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNLICOther6129