Individual
JOHN EDWIN SLETTEDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, CNP
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1336786
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154380939
—
MN
05
—
36090500
—
WI
Enumeration date
03/21/2006
Last updated
05/12/2011
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