Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 07-990 | AZ |
Y | 175F00000X | Naturopath | 1019 | MN |
NPI | 1124271333 |
---|---|
Provider Name | Dr. Nita Jill Champion |
First Address | Minnetonka, MN 55305-1502 |
Second Address | Minnetonka, MN 55305-1502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2008 |
Last Update Date | 10/06/2014 |