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Jerrol Noller Md Ltd
Medical Specialty Clinic/Center in Coon Rapids, Minnesota
NPI 1821257593

Jerrol Noller Md Ltd is a Medical Specialty Clinic/Center based in Anoka, MN and is specialized in Medical Specialty. Jerrol Noller Md Ltd practices in Coon Rapids, MN. The NPI Number for Jerrol Noller Md Ltd is 1821257593 and holds a License No. 23068 (Minnesota).

The current practice location address for Jerrol Noller Md Ltd is 3863 Coon Rapids Blvd Nw, Coon Rapids, MN and can be reached out via phone at 763-433-8300 and via fax at 763-433-8308.

Location: 3863 Coon Rapids Blvd Nw, Coon Rapids, MN, 55303-2747
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1821257593
Provider Name
Jerrol Noller Md Ltd
Credential
Provider Entity Type
Organization
Address
3863 Coon Rapids Blvd Nw, Coon Rapids, MN, 55303-2747
Phone Number
763-433-8300
Fax Number
763-433-8308
Provider Enumeration Date
06/06/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
774888400 05 MN
institution
Provider Business Practice Location Address Details
Address
3863 Coon Rapids Blvd Nw
City
Coon Rapids
State
Minnesota
Zip
55433-2518
Phone Number
763-433-8300
Fax Number
763-433-8308
person
Provider Business Mailing Address Details
Address
3863 Coon Rapids Blvd Nw
City
Coon Rapids
State
Minnesota
Zip
55433-2518
Phone Number
763-433-8300
Fax Number
763-433-8308
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
23068 (Minnesota)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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