Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | KHU-106688 | MN |
NPI | 1306430319 |
---|---|
Provider Name | Kristianna L Huesmann |
First Address | Pequot Lakes, MN 56472-3111 |
Second Address | Pequot Lakes, MN 56472-3111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2021 |
Last Update Date | 22/02/2021 |