Provider Demographics
NPI:1699104711
Name:MILENDER, NATHAN ANDREW (RN, FNP)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:ANDREW
Last Name:MILENDER
Suffix:
Gender:M
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8586 LAKE JANE TRL N
Mailing Address - Street 2:
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042-9516
Mailing Address - Country:US
Mailing Address - Phone:651-773-4816
Mailing Address - Fax:
Practice Address - Street 1:1750 ROBERT ST S
Practice Address - Street 2:
Practice Address - City:WEST SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3919
Practice Address - Country:US
Practice Address - Phone:651-455-6671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-165347-2363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily