Individual
KIMI LARSON BROUHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(612) 813-6100
Mailing address
16812 STIRRUP LN, EDEN PRAIRIE, MN 55347-3339
(612) 418-1584
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
172717-5
MN
Other
Enumeration date
10/27/2012
Last updated
05/17/2013
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