Maple Psychiatry | |
1873 Shryer Ave W Roseville MN 55113-5413 | |
(425) 446-0012 | |
Not Available |
Full Name | Maple Psychiatry |
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Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
Location | 1873 Shryer Ave W, Roseville, Minnesota |
Authorized Official Name and Position | Nicole Burkette Ikebata (PSYCHIATRIST) |
Authorized Official Contact | 4254460012 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Maple Psychiatry 202 N Cedar Ave Ste 1 Owatonna MN 55060-2306 Ph: (425) 446-0012 | Maple Psychiatry 1873 Shryer Ave W Roseville MN 55113-5413 Ph: (425) 446-0012 |
NPI Number | 1194593566 |
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Provider Enumeration Date | 12/15/2023 |
Last Update Date | 12/15/2023 |
Certification Date | 12/15/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194593566 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
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