Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 32860 | MN |
NPI | 1013953488 |
---|---|
Provider Name | Kathryn G Flory |
First Address | Maple Grove, MN 55369-4768 |
Second Address | Maple Grove, MN 55369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 20/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
762502200 | (05) | MN |
E43600 | (02) | MN |