Individual
GRACE LOUISE FAUTSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6401 FRANCE AVE S OFC LL3-F1, EDINA, MN 55435-2104
(952) 924-5000
(612) 365-0337
Mailing address
6401 FRANCE AVE S # LL3-F1, EDINA, MN 55435-2104
(952) 924-5888
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11170
MN
Other
Enumeration date
01/09/2024
Last updated
06/03/2024
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