Individual
MS. DENETTE MAMIE PHILLIPS DUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10527 165TH ST W, LAKEVILLE, MN 55044-5725
(952) 955-4110
Mailing address
PO BOX 20411, BLOOMINGTON, MN 55420-0411
(612) 702-2222
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2477500
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2024012143
MN
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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