Individual
DR. STACEY KAY TYSVER- NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
425 7TH ST NW, CASS LAKE, MN 56633-3360
(218) 335-3267
Mailing address
425 7TH ST NW, CASS LAKE, MN 56633-3360
(218) 335-3267
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
119695
MN
Other
Enumeration date
01/07/2010
Last updated
02/24/2016
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