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Individual

TWILA JOHANNA MURSU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
450 EASTVOLD AVE, ORTONVILLE, MN 56278-1133
(320) 839-6157
(320) 839-6159
Mailing address
48155 143RD ST, BIG STONE CITY, SD 57216-5519
(605) 924-0606
(320) 839-6159

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5231
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
CP001247
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1295256964
MN
Enumeration date
07/03/2017
Last updated
02/28/2024
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