| Doctor Name: | NANCY ENTGELMEIER |
| NPI Number: | 1013976554 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | R0938017 |
| Business Practice Address: | 347 N Smith Ave Childrens Specialty Clinic Feeding Clinic Stpl Mpls St Paul, MN - 55102 |
| Business Phone Number: | 6512206446 |
| Business Fax Number: | |
| Mailing Address: | 2910 Centre Pointe Dr 35-121a, Childrens Health Care ROSEVILLE |
| State: | MN |
| Postal Code: | 55113 |
| Phone Number: | 6518552327 |
| Fax Number: | 6518552310 |
| NPI Enumeration Date: | 03/22/2006 |
| NPI Last Update Date: | 10/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | R0938017 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |