Individual
MACKENSIE EDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
12310 SINGLETREE LN APT 2334, EDEN PRAIRIE, MN 55344-7983
(612) 322-0990
Mailing address
12310 SINGLETREE LN APT 2334, EDEN PRAIRIE, MN 55344-7983
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
820592
MN
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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