Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 1846098 | MN |
NPI | 1003230020 |
---|---|
Provider Name | Kate Chies |
First Address | Robbinsdale, MN 55422-2926 |
Second Address | Robbinsdale, MN 55422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2014 |
Last Update Date | 20/06/2018 |