Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 458 | MN |
N | 213ES0131X | Foot Surgery | 458 | MN |
NPI | 1003897133 |
---|---|
Provider Name | Dr. Karenthea W. Rouw |
First Address | Saint Cloud, MN 56303-4491 |
Second Address | Saint Cloud, MN 56303-4491 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 23/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
834025100 | (05) | MN |
U16804 | (02) | MN |