Nicholas Louis Bormann, MD
Psychiatry & Neurology, Psychiatry in Albert Lea, MN. Individual provider (NPI-1).
NPI number1750879367
StatusActive
Last updated in NPPESJun 28, 2023
Details
- NPI
- 1750879367
- Entity type
- Individual (NPI-1)
- Name
- Nicholas Louis Bormann
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 30, 2018
- Certification date
- Jun 28, 2023
- Last updated
- Jun 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 73141 | MN | Yes |
| 2084P0802X | Psychiatry & Neurology, Addiction Psychiatry | MD-47108 | IA | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
404 Fountain StAlbert Lea, MN 56007-2406
Phone 507-373-2384
Mailing address
408 W Fountain StAlbert Lea, MN 56007-2437
Phone 507-377-6411
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