Provider Information for 1457889909
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Dr. NICOLE GUNASEKERA MD, MBA
Sex: Female
NPI: 1457889909
Last Updated: 2025-03-15
Certification Date: 2025-03-15
Certification Date: 2025-03-15
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1457889909 | ||||||||||||
| Enumeration Date | 2017-05-30 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 14305 SOUTHCROSS DR W STE 110 BURNSVILLE, MN 55306-7011 United States Phone: 651-340-1064 | Fax:651-330-0429 | ||||||||||||
| Primary Practice Address | 14305 SOUTHCROSS DR W STE 110 BURNSVILLE, MN 55306-7011 United States Phone: 651-340-1064 | Fax:651-330-0429 | ||||||||||||
| Secondary Practice Address(es) | |||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|