Organization
IRIS REPRODUCTIVE PSYCHIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA ANN HUGUELET DNP APRN CNS (OWNER/OPERATER)
(860) 406-4747
Entity
Organization
Contact information
Practice address
1500 MCANDREWS ROAD W, STE 227, BURNSVILLE, MN 55337
(860) 406-4747
(612) 437-4759
Mailing address
1500 MCANDREWS RD W, 227, BURNSVILLE, MN 55337-4432
(860) 406-4747
(612) 437-4759
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R134588-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168946100
—
MN
Enumeration date
03/30/2016
Last updated
03/30/2016
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