NPI | 1114917788 |
---|---|
Former Name | KARIN KRISTINA JORGENSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R1419920) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R141992-0) |
Enumeration Date | 2005-10-25 |
Last Update Date | 2021-03-11 |