Individual
MARY BETH NEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
9766 FALLON AVE NE STE 102, MONTICELLO, MN 55362-4589
(763) 272-1500
(763) 272-1503
Mailing address
9766 FALLON AVENUE SUITE 102, MONTICELLO, MN 55362-4589
(763) 272-1500
(763) 272-1503
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R89486-3
MN
Other
Enumeration date
06/28/2010
Last updated
04/07/2016
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