Individual
TRACE MOWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1102 E 4TH ST, DULUTH, MN 55805-2219
(218) 310-8896
(218) 310-8896
Mailing address
1102 E 4TH ST, DULUTH, MN 55805-2219
(218) 206-9390
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12541
MN
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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