Individual
STACY WAHL SLETTUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1216 RYANS RD STE 3, WORTHINGTON, MN 56187-1781
(507) 375-6522
(507) 372-6573
Mailing address
1216 RYANS RD STE 3, WORTHINGTON, MN 56187-1781
(507) 375-6522
(507) 372-6573
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2193
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118293500
—
MA
Enumeration date
08/15/2005
Last updated
07/15/2024
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