Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 780 | WI |
Y | 363L00000X | Nurse Practitioner | R218963-1 | MN |
NPI | 1003837196 |
---|---|
Provider Name | Frances Anne Antkowiak |
First Address | Willmar, MN 56201-3556 |
Second Address | Willmar, MN 56201-3556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 25/07/2014 |