Individual
STARLETT PAIGE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2680 ARTHUR ST, ROSEVILLE, MN 55113-1339
(651) 917-3634
Mailing address
1125 LAGOON AVE UNIT 206, MINNEAPOLIS, MN 55408-5144
(769) 229-5640
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
512789
MN
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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