Individual
SARA DEZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 656-7020
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
R 213472-5
MN
364S00000X
Clinical Nurse Specialist
Primary
CNS 0507
MN
Other
Enumeration date
05/27/2016
Last updated
07/13/2016
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