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Individual

LISA HOLTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4897 MILLER TRUNK HWY STE 121, HERMANTOWN, MN 55811-1696
(218) 302-1966
Mailing address
1408 MAPLE GROVE RD APT 206, DULUTH, MN 55811-4514
(218) 721-8890

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
825764
MN

Other

Enumeration date
07/18/2025
Last updated
07/18/2025
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