Provider Demographics
NPI:1780620120
Name:NILSEN, CINDY EILEEN (MS, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:EILEEN
Last Name:NILSEN
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:EILEEN
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-A
Mailing Address - Street 1:5565 BLAINE AVE
Mailing Address - Street 2:STE 225
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076
Mailing Address - Country:US
Mailing Address - Phone:651-888-7800
Mailing Address - Fax:651-645-6166
Practice Address - Street 1:5565 BLAINE AVE
Practice Address - Street 2:STE 225
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076
Practice Address - Country:US
Practice Address - Phone:651-888-7800
Practice Address - Fax:651-452-9282
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6223231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN607525800Medicaid