Individual
MICHELLE HALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4251 TIMBERRIDGE LN APT E, HERMANTOWN, MN 55811-4017
(218) 830-1029
Mailing address
4251 TIMBERRIDGE LN APT E, HERMANTOWN, MN 55811-4017
(218) 830-1029
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2397517
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2397517
REGISTERED NURSE
MN
Enumeration date
09/15/2021
Last updated
09/15/2021
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