Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 000000 | MN |
NPI | 1114289790 |
---|---|
Provider Name | Amanda Kohlmeier |
First Address | Edina, MN 55435-2137 |
Second Address | Edina, MN 55435-2137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 29/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9034781 | ABOG CERTIFICATION ID NUMBER (01) |