Individual
MS. RANDI SUSAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
106 4TH AVE N, FERGUS FALLS, MN 56537-1034
(218) 998-3778
(218) 998-3187
Mailing address
12327 LITTLE PINE RD SW, BRAINERD, MN 56401
(218) 829-9747
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L66443-3
MN
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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