Provider Demographics
NPI:1144629726
Name:NOECKER, CARINA MARIE (DNP, RN, AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:MARIE
Last Name:NOECKER
Suffix:
Gender:F
Credentials:DNP, RN, AGPCNP-BC
Other - Prefix:
Other - First Name:CARINA
Other - Middle Name:MARIE
Other - Last Name:LINDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, RN , AGPCNP-BC
Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4730 CHICAGO AVE
Practice Address - Street 2:MS 26602G
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3570
Practice Address - Country:US
Practice Address - Phone:952-883-6805
Practice Address - Fax:952-853-8864
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2589363L00000X
MNR201979-8363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology