Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 54171 | MN |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 54171 | MN |
N | 207RH0002X | Hospice and Palliative Medicine | 54171 | MN |
NPI | 1518288968 |
---|---|
Provider Name | Dr. Jennifer M Kuyava |
First Address | Minneapolis, MN 55407-1321 |
Second Address | Saint Paul, MN 55102-2344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2010 |
Last Update Date | 24/07/2017 |