Individual
CARLY FELICETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8990 SPRINGBROOK DR NW, #250, COON RAPIDS, MN 55433
(764) 360-5348
Mailing address
3358 LINCOLN ST NE, MINNEAPOLIS, MN 55418-1454
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
091718
MN
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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