| Maple Psychiatry | |
|
1873 Shryer Ave W Roseville MN 55113-5413 | |
| (425) 446-0012 | |
| Not Available |
| Full Name | Maple Psychiatry |
|---|---|
| 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 |
|---|---|
| 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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