Individual
LACEY MARIE SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
725 ELM ST, SUITE 1200, ALEXANDRIA, MN 56308-1760
(320) 815-9441
(320) 763-4127
Mailing address
725 ELM ST, SUITE 1200, ALEXANDRIA, MN 56308-1760
(320) 815-9441
(320) 763-4127
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R169691-8
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R169691-8
RN
MN
Enumeration date
08/17/2009
Last updated
08/17/2009
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