Ekholm, Melissa Marie

Ekholm, Melissa Marie is an individual health care provider with primary practice located at 6500 Excelsior Blvd , St Louis Park MN 55426-4702. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Ekholm, Melissa Marie can be contacted via phone (952) 993-1000.

Contact Information

Primary practice address
6500 Excelsior Blvd St Louis Park MN 55426-4702
Phone: (952) 993-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X R157852-8 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R1578528 Minnesota

Profile Details

NPI number 1932208436
LBN Legal business name Ekholm, Melissa Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated Sep 28th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932208436 NPPES
Minnesota MEDICAID ENROLLED
Minnesota MEDICAID ENROLLED

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