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1467025304
TINA BENGTSON
ANNANDALE, MN
NPI
1467025304
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Former Name
TINA MICKOLICHEK
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MN 8311)
Enumeration Date
2021-07-19
Last Update Date
2022-11-17
Business Address
TINA BENGTSON NP-C
440 ELM ST E
ANNANDALE, MN 55302-1109
Phone number: 320-274-3744
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Mailing Address
TINA BENGTSON NP-C
8936 LYNDALE AVE S
BLOOMINGTON, MN 55420-2742
Phone number: 952-881-0163
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