Individual
MS. MARY RUTH FISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
550 MAIN ST, 230, NEW BRIGHTON, MN 55112-3271
(612) 326-7600
Mailing address
550 MAIN ST, 230, NEW BRIGHTON, MN 55112-3271
(612) 326-7600
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L41807
MN
Other
Enumeration date
05/17/2011
Last updated
05/17/2011
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