Provider Demographics
NPI:1407661259
Name:BREMMER, NIKALA MARIE (CNM, APRN)
Entity type:Individual
Prefix:
First Name:NIKALA
Middle Name:MARIE
Last Name:BREMMER
Suffix:
Gender:
Credentials:CNM, APRN
Other - Prefix:
Other - First Name:NIKALA
Other - Middle Name:M
Other - Last Name:SHENOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2122 HIGHLAND PL
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2021
Mailing Address - Country:US
Mailing Address - Phone:405-323-8670
Mailing Address - Fax:
Practice Address - Street 1:153 CESAR CHAVEZ ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-2226
Practice Address - Country:US
Practice Address - Phone:651-602-7500
Practice Address - Fax:651-602-7580
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN608367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife