Provider Demographics
NPI:1881984474
Name:MUELLER, CARRIE ANN (RN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:MUELLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17264 LAKEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:EDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55329-9465
Mailing Address - Country:US
Mailing Address - Phone:320-267-7301
Mailing Address - Fax:
Practice Address - Street 1:17264 LAKEWOOD RD
Practice Address - Street 2:
Practice Address - City:EDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55329-9465
Practice Address - Country:US
Practice Address - Phone:320-267-7301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 197138-7163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse