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Contact Information

SANDRA L IVERSON, CPNP
NORTH METRO PEDIATRICS 10081 DOGWOOD STREET NW
SUITE 100
COON RAPIDS, MN55448
 Phone: 763-783-3722
 Fax: 763-783-7944
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for SANDRA L IVERSON · (Female)

NPI # 1790886976
Status Active
Credentials CPNP (Certified Pediatric Nurse Practitioner)
Entity Individual
Enumeration date 09/26/2006
Last updated 10/03/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • MN License # R 063381-7
  • MN Medicaid 941742700
  • MT Medicaid 4305613
  • WI Medicaid 43929100
  • Other 1576851 AMERICAS PPO/ARAZ
  • Other A520 CHAMPUS
  • Other 12-00987 MEDICA-CHOICE
  • Other 12-09026 MEDICA-PRIMARY
  • Other 1043948 PREFERRED ONE
  • Other P00014192 RAILROAD MEDICARE
  • MN Other 025A2IV BCBS
  • MN Other 207209 FAIRVIEW
  • MN Other HP21983 HEALTH PARTNERS
  • MN Other 104736 U CARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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