NPI | 1780793935 |
---|---|
Former Name | JODI LYNN KYNDBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 1900) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R128893-1) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2021-06-08 |