Individual
CAROL DAWN DEHAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5995 LEESON LN, RED WING, MN 55066-1131
(651) 764-1018
Mailing address
5995 LEESON LN, RED WING, MN 55066-1131
(651) 764-1018
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1806229
MN
Other
Enumeration date
12/26/2020
Last updated
12/26/2020
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