Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD50844 | TN |
N | 208600000X | Surgeon | MD50844 | TN |
Y | 2086S0102X | Surgical Critical Care | 59620 | MN |
N | 2086S0127X | Trauma Surgeon | 50844 | TN |
NPI | 1346579349 |
---|---|
Provider Name | Krista Wilhelmson |
First Address | Duluth, MN 55805-1950 |
Second Address | Duluth, MN 55805-1951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2009 |
Last Update Date | 07/12/2015 |