Basic Information
| Provider Information | |||||||||
| NPI: | 1437158490 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARLIEN | ||||||||
| FirstName: | LOUISE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1007 | ||||||||
| Address2: | |||||||||
| City: | HOWARD LAKE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553491007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524423190 | ||||||||
| FaxNumber: | 9524423185 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 6TH ST | ||||||||
| Address2: | |||||||||
| City: | HOWARD LAKE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553495647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524423190 | ||||||||
| FaxNumber: | 9524423185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2005 | ||||||||
| LastUpdateDate: | 06/10/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R0921574 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 690945100 | 05 | MN | MEDICAID | R0921574 | 01 | MN | RN LICENSE | OTHER |