Individual
ALYSSA GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CNP, NNP-BC
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 273-7032
Mailing address
2370 STONECREST PATH NW, PRIOR LAKE, MN 55372-4006
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
9771
MN
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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