Individual
MRS. ADRIANA ADDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
100 EVERGREEN SQ SW, PINE CITY, MN 55063-2000
(320) 629-6721
Mailing address
257 W SAINT GEORGE AVE, GRANTSBURG, WI 54840-7827
(715) 463-5317
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
160486-30
WI
363LF0000X
Family Nurse Practitioner
Primary
3164
MN
363LF0000X
Family Nurse Practitioner
3647
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190205392
—
MN
05
—
190205392
—
WI
Enumeration date
08/21/2008
Last updated
01/22/2019
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