Individual
DR. KENNETH MCRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, APRN, CNP
Contact information
Practice address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407
(763) 236-5000
Mailing address
5829 44TH AVE SOUTH, MINNEAPOLIS, MN 55417-2718
(612) 817-1211
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3895
MN
363LA2100X
Acute Care Nurse Practitioner
Primary
3895
MN
363LA2200X
Adult Health Nurse Practitioner
3895
MN
363LG0600X
Gerontology Nurse Practitioner
3895
MN
363LP2300X
Primary Care Nurse Practitioner
3895
MN
Other
Enumeration date
07/14/2015
Last updated
06/26/2023
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