Individual
DESIREE M BERTILRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1720 HIGHWAY 59 S, THIEF RIVER FALLS, MN 56701-4331
(218) 681-4747
(218) 683-2595
Mailing address
1720 HIGHWAY 59 S, THIEF RIVER FALLS, MN 56701-4331
(218) 681-4747
(218) 683-2595
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R156913-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0836113000
—
MN
Enumeration date
11/15/2007
Last updated
01/25/2008
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