| NPI | 1306376686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE ANN ROGGENKAMP Owner 320-297-0633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN 2204341) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MN 353016) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |