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Individual

CHAR LO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
1120 WAYZATA BLVD E STE 210, WAYZATA, MN 55391-1915
(952) 443-4600
Mailing address
1120 WAYZATA BLVD E STE 210, WAYZATA, MN 55391-1915
(952) 443-4600
(952) 443-4604

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
13254
MN

Other

Enumeration date
08/25/2025
Last updated
08/25/2025
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