Individual
CARY MARTHA ROUSSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 W MAIN ST STE 11, ANOKA, MN 55303-2000
(763) 753-8658
Mailing address
14201 XENON ST NW UNIT 11, RAMSEY, MN 55303-2977
(763) 227-3388
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R152982-3
MN
163WH0200X
Home Health Registered Nurse
R152982-3
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FEMALE
RN
—
01
—
NA
NA
—
Enumeration date
01/20/2020
Last updated
01/20/2020
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