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Individual

MRS. MAUREEN LEE RANDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
927 TRETTEL LN, CLOQUET, MN 55720-1345
(218) 879-1227
(218) 878-3718
Mailing address
417 SKYLINE BLVD, CLOQUET, MN 55720-1198
(218) 879-1271
(218) 655-0017

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP 4552
MN
363LF0000X
Family Nurse Practitioner
CNP4552
MN

Other

Enumeration date
06/09/2016
Last updated
11/05/2019
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