Provider Demographics
NPI:1457042137
Name:SAINT GIANNA OBSTETRICS FERTILITY AND SURGERY PLLC
Entity Type:Organization
Organization Name:SAINT GIANNA OBSTETRICS FERTILITY AND SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:NORDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-653-0062
Mailing Address - Street 1:4465 WHITE BEAR PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-7623
Mailing Address - Country:US
Mailing Address - Phone:651-653-0062
Mailing Address - Fax:651-653-0288
Practice Address - Street 1:4465 WHITE BEAR PKWY STE 2
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-7623
Practice Address - Country:US
Practice Address - Phone:651-653-0062
Practice Address - Fax:651-653-0288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty