Individual
MISTY MICHELLE FORNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8210 FAWN LAKE DR NE, STACY, MN 55079-9322
(612) 725-8080
Mailing address
8210 FAWN LAKE DR NE, STACY, MN 55079-9322
(612) 725-8080
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R-1483008
MN
Other
Enumeration date
03/31/2026
Last updated
03/31/2026
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