Nyholm, Brett W

Nyholm, Brett W is an individual health care provider with primary practice located at 6200 Shingle Creek Pkwy Suite 250, Brooklyn Center MN 55430-2128. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Nyholm, Brett W can be contacted via phone (763) 544-0696.

Contact Information

Primary practice address
6200 Shingle Creek Pkwy Suite 250 Brooklyn Center MN 55430-2128
Phone: (763) 544-0696
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 44788 Minnesota

Profile Details

NPI number 1255305355
LBN Legal business name Nyholm, Brett W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Nov 10th, 2020 - about 6 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 1255305355 NPPES
Minnesota MEDICAID 809652000
Minnesota Other 143225C028
Minnesota Other 3100381
Minnesota Other HP62024
Minnesota Other 123D3NY
Minnesota Other 960931050396
Minnesota Other 020
Minnesota MEDICAID 34779200

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