Individual
KATHERINE VICHOREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
301 MAIN AVE S, PARK RAPIDS, MN 56470-1550
(509) 222-1275
Mailing address
4717 RIDGEWOOD DR, MOOSE LAKE, MN 55767-9223
(651) 303-9120
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
54797
ID
363L00000X
Nurse Practitioner
Primary
54797
ID
Other
Enumeration date
01/11/2017
Last updated
08/28/2019
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