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1043047012
HOLLY ANNETTE DERIFIELD
SAINT CLOUD, MN
NPI
1043047012
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Former Name
HOLLY ANNETTE BACHMAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MN 608884)
Enumeration Date
2024-09-16
Last Update Date
2024-09-16
Business Address
HOLLY ANNETTE DERIFIELD LPN
4801 VETERANS DR
SAINT CLOUD, MN 56303-2015
Phone number: 320-252-1670
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Mailing Address
HOLLY ANNETTE DERIFIELD LPN
640 CHERRY LN
ROYALTON, MN 56373-4405
Phone number: 320-434-0689
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