Individual
MARY ELLEN BRANDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1418 WOODBRIDGE ST, SAINT PAUL, MN 55117-4413
(651) 487-5544
Mailing address
1418 WOODBRIDGE ST, SAINT PAUL, MN 55117-4413
(651) 487-5544
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L 052191-6
MN
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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