Bertilrud, Desiree M

Bertilrud, Desiree M is an individual health care provider with primary practice located at 1720 Highway 59 S , Thief River Falls MN 56701-4331. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Bertilrud, Desiree M can be contacted via phone (218) 681-4747.

Contact Information

Primary practice address
1720 Highway 59 S Thief River Falls MN 56701-4331
Phone: (218) 681-4747
Fax: (218) 683-2595
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R156913-9 Minnesota

Profile Details

NPI number 1164603460
LBN Legal business name Bertilrud, Desiree M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2007
Last updated Jan 25th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164603460 NPPES
Minnesota MEDICAID 0836113000

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