Individual
ELLEN SUE MANTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
11800 HIGHWAY 18, BRAINERD, MN 56401
(218) 855-1115
Mailing address
11800 E. HWY 18, BRAINERD, MN 56401
(218) 855-1115
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R080884-6
MN
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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