| NPI | 1790497865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ELAINE HENDERSON Nurse Practitioner 507-884-4856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-12-20 |
| Last Update Date | 2022-12-20 |