Individual
LARISSA NEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17665 KENWOOD TRL, LAKEVILLE, MN 55044-9455
(952) 435-3784
Mailing address
17665 KENWOOD TRL, LAKEVILLE, MN 55044-9455
(952) 435-3784
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
124800
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124800
PHARMACIST LICENSE
MN
Enumeration date
11/16/2020
Last updated
11/16/2020
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