Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 102649 | MN |
Y | 2084N0402X | Child Neurologist | 102649 | MN |
NPI | 1164534533 |
---|---|
Provider Name | Dr. Kimberly Ann Krohn |
First Address | Duluth, MN 55805-1951 |
Second Address | Duluth, MN 55805-1951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 24/01/2022 |