Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 4695 | MN |
NPI | 1033145727 |
---|---|
Provider Name | Dr. Christine Ann Hess Ingbretson |
First Address | Ham Lake, MN 55304-6323 |
Second Address | Ham Lake, MN 55304-5432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 15/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V06218 | (02) | MN |