| NPI | 1134632680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BLAIR CFO 320-255-5665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 104100000X Social Worker |
| 207RH0003X Internal Medicine Hematology & Oncology | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2085R0001X Radiology Radiation Oncology | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 364S00000X Clinical Nurse Specialist | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2021-01-28 |