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Individual

LAURIE A CHITTUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Mailing address
PO BOX 2010, FARGO, ND 58122-2484
(701) 234-1230
(701) 234-2045

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
CP001095
SD
363LF0000X
Family Nurse Practitioner
Primary
R2446727
MN

Other

Enumeration date
06/17/2016
Last updated
03/17/2018
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