Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 67447 | MN |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD466709 | PA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | R-09948 | IA |
NPI | 1003227489 |
---|---|
Provider Name | Dr. Kendall Krystyna Tasche |
First Address | Rochester, MN 55905-0002 |
Second Address | Rochester, MN 55905-4238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2014 |
Last Update Date | 30/09/2020 |