Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 01073683 | IN |
Y | 2080P0210X | Pediatric Nephrologist | 66265 | MN |
NPI | 1639460439 |
---|---|
Provider Name | Anne Marie Kouri |
First Address | Minneapolis, MN 55454-1450 |
Second Address | Minneapolis, MN 55454-1450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2011 |
Last Update Date | 02/12/2019 |