Individual
MICHELLE HOLLIS FASEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(847) 331-0221
Mailing address
1891 JAMES AVE, SAINT PAUL, MN 55105-1716
(847) 331-0221
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2372
MN
Other
Enumeration date
08/05/2019
Last updated
01/12/2020
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