Organization
MIETUS NP MENTAL HEALTH, LLC
Active
Other names
Mental Wellbeing NP
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY THOMPSON MIETUS APRN, CNP (SELF-EMPLOYED NURSE PRACTITIONER)
(612) 226-2912
Entity
Organization
Contact information
Practice address
428 MINNESOTA ST STE 500, SAINT PAUL, MN 55101-2666
(612) 662-9604
(612) 474-9072
Mailing address
5100 42ND AVE S, MINNEAPOLIS, MN 55417-1615
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/12/2019
Last updated
07/31/2023
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