Individual provider · Type 1 NPI
Kisuk Bae Wirtz
Licensed Practical Nurse · Detroit Lakes, MN
Practice location
114 Frazee St E, 47854 Swiss Lane
Detroit Lakes, MN 56501-3502
Mailing address
PO Box 884, 47854 Swiss Lane
Ponsford, MN 56575
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | L48823-7 (MN) |
Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Another provider at this address
Other licensed practical nurse providers in Detroit Lakes
About NPI 1457672800
Kisuk Bae Wirtz's National Provider Identifier is 1457672800, issued on Jun 21, 2010. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Detroit Lakes, MN. The record was last updated on Jun 21, 2010.