NPI | 1255742003 |
---|---|
Former Name | KATIE TRELSTAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R-169411-4) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R-169411-4) |
Enumeration Date | 2014-05-14 |
Last Update Date | 2020-08-10 |