Individual
MRS. MICHELLE LIGHT BLISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3799
(612) 863-4000
Mailing address
1435 STANFORD AVE, SAINT PAUL, MN 55105-2416
(541) 908-3513
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7235
MN
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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