Individual
ANGELA JEAN MOOTHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 844-2300
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 844-2300
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
1603668
MN
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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