Individual
MRS. JENELL RUTH MITTENESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CFNP
Contact information
Practice address
101 WILLMAR AVE SW, WILLMAR, MN 56201-3556
(320) 214-6870
Mailing address
101 WILLMAR AVE SW, WILLMAR, MN 56201-3556
(320) 231-5000
(320) 231-5067
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1371848
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
547642100
—
MN
Enumeration date
04/17/2007
Last updated
03/28/2023
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