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Individual

KYLE LAURENCE SLAATHAUG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
3001 SANFORD PKWY, THIEF RIVER FALLS, MN 56701-2700
(218) 681-4747
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9419
(605) 312-9802

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R42775
ND
363LF0000X
Family Nurse Practitioner
R42775
ND

Other

Enumeration date
10/21/2022
Last updated
03/16/2023
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