Individual
MS. JEAN MARIE KUMMER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4831 RICHARD LN, SAINT PAUL, MN 55122-2784
(651) 452-8244
Mailing address
4831 RICHARD LN, SAINT PAUL, MN 55122-2784
(651) 452-8244
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3286
MN
363LF0000X
Family Nurse Practitioner
Primary
3286
MN
363LF0000X
Family Nurse Practitioner
R85803-2
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90561900
—
MN
Enumeration date
08/02/2006
Last updated
11/09/2020
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