Provider Demographics
NPI:1164221099
Name:PARK NICOLLET METHODIST HOSPITAL
Entity type:Organization
Organization Name:PARK NICOLLET METHODIST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BJORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-883-7469
Mailing Address - Street 1:14000 FAIRVIEW DR STE 2818
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-5713
Mailing Address - Country:US
Mailing Address - Phone:952-977-0856
Mailing Address - Fax:
Practice Address - Street 1:14000 FAIRVIEW DR STE 2818
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-5713
Practice Address - Country:US
Practice Address - Phone:952-977-0856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy