Individual
THIA MARIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
(218) 545-4456
Mailing address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R1675405
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1675405
MINNESOTA BOARD OF NURSING
MN
Enumeration date
10/02/2013
Last updated
12/04/2015
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