Provider Demographics
NPI:1386302701
Name:KNUTE NELSON
Entity type:Organization
Organization Name:KNUTE NELSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GUGISBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-763-6653
Mailing Address - Street 1:420 12TH AVE E
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2612
Mailing Address - Country:US
Mailing Address - Phone:320-763-6653
Mailing Address - Fax:
Practice Address - Street 1:420 12TH AVE E
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2612
Practice Address - Country:US
Practice Address - Phone:320-763-6653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KNUTE NELSON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health