Healthcare Provider Details

I. General information

NPI: 1437013968
Provider Name (Legal Business Name): DENISE MARIE SJODIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 NW 7TH ST
BRAINERD MN
56401-2912
US

IV. Provider business mailing address

722 NW 7TH ST
BRAINERD MN
56401-2912
US

V. Phone/Fax

Practice location:
  • Phone: 218-825-2603
  • Fax:
Mailing address:
  • Phone: 218-825-2603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1437517
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: