Individual
AUDREY MIE PARK-SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35484
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31795100
—
WI
05
—
616700400
—
MN
Enumeration date
07/09/2006
Last updated
05/09/2011
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