Individual
LISA CAROL CARRLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
928 8TH ST SE # SE5, DETROIT LAKES, MN 56501-2839
(218) 847-1676
Mailing address
928 8TH ST SE, DETROIT LAKES, MN 56501-2839
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11559
MN
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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