Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 6614 | MN |
NPI | 1619532041 |
---|---|
Provider Name | Dr. Kylie Jo Norell |
First Address | Windom, MN 56101-1006 |
Second Address | Windom, MN 56101-1287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2019 |
Last Update Date | 14/04/2021 |