Nicolle M. Lande PA
Physician Assistant in St Paul, MN(View on Map)
Full Name
Nicolle Michelle Lande PA
NPI Number
1881671162
NPI Type
Individual Provider
Gender
Female
Enumeration Date
12/28/2005
Specialties
(Taxonomies)Licenses
State
Minnesota
License Number
9821
Contact
Information
Purpose
Mailing
Location
Address
2550 UNIVERSITY AVENUE WEST
2550 UNIVERSITY AVENUE WEST
City
St Paul
St Paul
State
MN
MN
Postal Code
55114
55114
Country
US
US
Telephone Number
(651) 645-3115
(651) 645-3115
Identifiers
Identifier
486965800
559K0LA
Identifier State
MN
MN
Identifier Issuer
Unknown
BCBS OF MN
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/08/2007