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Individual

CORISSA LEE HACKMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
106 4TH AVE NORTH, FERGUS FALLS, MN 56537-1034
(218) 998-3778
(218) 998-3187
Mailing address
212 SUMMIT AVE, DETROIT LAKES, MN 56501

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R1858947
MN

Other

Enumeration date
07/25/2008
Last updated
07/25/2008
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