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1427355783
TRISTA LEE-IREY HENRICKSON
ROSEVILLE, MN
NPI
1427355783
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MN L621887)
Enumeration Date
2011-02-23
Last Update Date
2011-02-23
Business Address
-- TRISTA LEE-IREY HENRICKSON
2800 CLEVELAND AVE N
ROSEVILLE, MN 55113-1126
Phone number: 651-642-1825
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Mailing Address
-- TRISTA LEE-IREY HENRICKSON
2800 CLEVELAND AVE N
ROSEVILLE, MN 55113-1126
Phone number: 651-642-1825
Copy
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