Individual
STACY CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(651) 301-1988
Mailing address
229 GLACIER AVE, SARTELL, MN 56377-1958
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2245148
MN
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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