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Organization

CRETILLI AND ASSOCIATES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PATRICIA K CRETILLI RN, CNS, PHD (PRESIDENT)
(612) 822-2714
Entity
Organization

Contact information

Practice address
5430 EDGEWATER BLVD, MINNEAPOLIS, MN 55417-2604
(612) 822-2714
Mailing address
5430 EDGEWATER BLVD, MINNEAPOLIS, MN 55417-2604
(612) 822-2714

Taxonomy

Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
77D30CR
BLUE CROSS BLUE SHIELD OF MINNESOTA
MN
Enumeration date
01/13/2010
Last updated
01/13/2010
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