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Individual

KATHI MARGARET HENRICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2501 KEENAN DR, ESSENTIA HEALTH INTERNATIONAL FALLS CLINIC, INTERNATIONAL FALLS, MN 56649-2181
(218) 283-4481
Mailing address
2501 KEENAN DR, ESSENTIA HEALTH INTERNATIONAL FALLS CLINIC, INTERNATIONAL FALLS, MN 56649-2181
(218) 283-4481

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R-084037-0
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
CNP 2672
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R-084037-0
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41198600
WI
05
559177500
MN
Enumeration date
07/07/2006
Last updated
05/25/2016
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