Individual
CAROL FILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-BC
Contact information
Practice address
3400 W 66TH ST, EDINA, MN 55435-2111
(952) 924-8117
Mailing address
3400 W 66TH ST, EDINA, MN 55435-2111
(952) 924-8117
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1517903
MN
Other
Enumeration date
11/07/2012
Last updated
12/16/2014
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