Healthcare Provider Details
I. General information
NPI: 1053268441
Provider Name (Legal Business Name): CLEAR SKY WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27345 COUNTY HIGHWAY 34
CALLAWAY MN
56521
US
IV. Provider business mailing address
912 MCKINLEY AVE # 311
DETROIT LAKES MN
56501-3504
US
V. Phone/Fax
- Phone: 218-845-3535
- Fax: 218-210-9420
- Phone: 218-845-3535
- Fax: 218-210-9420
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHANNA
NELLIE
CHRISTENSEN
Title or Position: OWNER
Credential: DNP
Phone: 218-845-3535