Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 36078 | MN |
NPI | 1033154661 |
---|---|
Provider Name | Julie K Drier |
First Address | Mankato, MN 56002-8674 |
Second Address | St Peter, MN 56082 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
49062800 | (05) | MN |
F59140 | (02) |