Individual
SUSAN J NISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
924 1ST ST NE, FARIBAULT, MN 55021-5441
(507) 333-3300
(507) 333-3211
Mailing address
924 1ST ST NE, FARIBAULT, MN 55021-5441
(507) 333-3300
(507) 333-3211
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35779
MN
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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