Individual
MS. SUSAN MARY MATHISON-YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
11800 STATE AVE, BRAINERD, MN 56401-7308
(218) 855-1115
(218) 855-1183
Mailing address
1509 72ND ST SW, LAKE SHORE, MN 56468-6874
(218) 568-7370
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
MN
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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