Dedra Lee Theisen RN

NPI 1154627297 - Registered Nurse - 163W00000X

NPI Details
NPI 1154627297
Gender Female
Enumeration Date 02/08/2011
Last Updated 02/08/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
14315 305TH AVE NW
PRINCETON MN, 55371-3648, US
Phone (612) 987-0234
Fax
Business Location
14315 305TH AVE NW
PRINCETON MN, 55371-3648, US
Phone (612) 987-0234
Fax
Toxanomy
Taxonomy Code 163W00000X
License State Minnesota
License Number R 185363-8
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According to our database, Dedra Lee Theisen RN NPI is 1154627297, taxonomy code is 163W00000X and license number is R 185363-8, license state is located at Minnesota. Dedra Lee Theisen RN physically located at 14315 305th Ave Nw, Princeton MN, 55371-3648. NPI Number Dedra Lee Theisen RN has the Individual type.

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1154627297 NPI number is provided on an as is basis without warranty of any kind. 1154627297 is maintained by the National Plan & Provider Enumeration System. The contents of Dedra Lee Theisen RN are for informational purposes only.