Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 6990 | NE |
Y | 2080P0202X | Pediatric Cardiologist | PT15761 | ND |
NPI | 1083053995 |
---|---|
Provider Name | Dr. Kristina K Rauser-Foltz |
First Address | Duluth, MN 55805-1951 |
Second Address | Fargo, ND 58103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2013 |
Last Update Date | 12/07/2019 |