NPI 1205272481

Nicole M Dishong, CNM

Practitioner Advanced Practice Midwife Edina, MN

Practice location

Address: 3625 W 65th St STE 100, Edina, MN 55435-2147
Phone: (952) 920-7001
Fax: (952) 920-2245
Mailing address: 10900 Wayzata Blvd STE 640, Minnetonka, MN 55305-5602

Registered specialties (3)

Advanced Practice Midwife Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367A00000X Licence 304 (MN)

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Registered Nurse

Nursing Service Providers Taxonomy 163W00000X Licence R44853 (NM)

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Midwife

Other Service Providers Taxonomy 176B00000X Licence CNM647 (NM)

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Registry record

NPI: 1205272481
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 May 2013
Record last updated: 21 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.