Individual
ANNA EILEEN WISTROM-THESING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2024 S 6TH ST, BRAINERD, MN 56401-4529
(218) 828-2880
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 828-7540
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP 4648
MN
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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