Individual
GREGORY H KJOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2509 CHERRYWOOD RD, MINNETONKA, MN 55305-2318
(952) 546-0595
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100929
MN
367500000X
Certified Registered Nurse Anesthetist
R45935
ND
372500000X
Chore Provider
039732
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052896
—
NC
Enumeration date
03/22/2006
Last updated
05/15/2018
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