Individual
RICHARD MIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1690749
MN
Other
Enumeration date
10/07/2024
Last updated
03/03/2025
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