Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 59393 | MN |
N | 207P00000X | Emergency Physician | 64191-20 | WI |
NPI | 1013270032 |
---|---|
Provider Name | Dr. Katherine Glasrud |
First Address | Minneapolis, MN 55407-3723 |
Second Address | Saint Paul, MN 55102-2344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 11/08/2015 |