Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 58132 | MN |
Y | 213ES0000X | Sports Medicine | 58132 | MN |
NPI | 1063758290 |
---|---|
Provider Name | Dr. Katherine N Nanos |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2012 |
Last Update Date | 12/05/2016 |