Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 56244 | MN |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 56244 | MN |
NPI | 1326330127 |
---|---|
Provider Name | Angela Aakhus |
First Address | Baxter, MN 56425-2223 |
Second Address | Bemidji, MN 56601-6380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2011 |
Last Update Date | 02/10/2020 |