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Individual

KIRSTEN DOUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP-PC

Contact information

Practice address
14001 RIDGEDALE DR STE 100, MINNETONKA, MN 55305-1781
(952) 473-0211
(952) 473-7908
Mailing address
14001 RIDGEDALE DR STE 100, MINNETONKA, MN 55305-1781
(952) 473-0211
(952) 473-7908

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5269
MN

Other

Enumeration date
04/26/2018
Last updated
04/26/2018
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