Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 56545 | WI |
N | 111NI0900X | Internist | 56545 | WI |
Y | 207RH0002X | Hospice and Palliative Medicine | 57810 | MN |
N | 207RH0002X | Hospice and Palliative Medicine | 7684 | AK |
NPI | 1255658985 |
---|---|
Provider Name | Kirstin S Lesage |
First Address | Duluth, MN 55805-1951 |
Second Address | Duluth, MN 55805-1951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2010 |
Last Update Date | 14/05/2015 |