Individual provider · Type 1 NPI

Nickolas C. Southwick, CRNA

Certified Registered Nurse Anesthetist · Plymouth, MN

NPI number 1023617362 Active

Practice location

14700 28th Ave N Ste 20
Plymouth, MN 55447-4876

Call (763) 559-3779 Map

Fax (763) 450-3986

Mailing address

PO Box 47159
Plymouth, MN 55447-0159

Other practice locations

2104 Northdale Blvd NW Ste 220, Coon Rapids, MN 55433-3046 · (763) 537-6000

Specialties and licenses

Taxonomy	Code	License
Certified Registered Nurse Anesthetist Primary	367500000X	2342009 (MN)

Certified Registered Nurse Anesthetist: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of creden…

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About NPI 1023617362

Nickolas C. Southwick, CRNA's National Provider Identifier is 1023617362, issued on Oct 19, 2020. The primary taxonomy on file is Certified Registered Nurse Anesthetist (367500000X), and the practice location is in Plymouth, MN. The record was last updated on Nov 24, 2025.