Provider Information for 1982318333
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NICHOLAS CROSS
Sex: Male
NPI: 1982318333
Last Updated: 2023-01-10
Certification Date: 2023-01-10
Certification Date: 2023-01-10
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1982318333 | ||||||||
| Enumeration Date | 2023-01-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2224 4TH AVE N APT 2 MINNEAPOLIS, MN 55405-1021 United States Phone: 740-701-3459 | Fax: | ||||||||
| Primary Practice Address | 2224 4TH AVE N APT 2 MINNEAPOLIS, MN 55405-1021 United States Phone: 740-701-3459 | Fax: | ||||||||
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