Individual
KERRI PENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16180 HASTINGS AVE SE, PRIOR LAKE, MN 55372-9227
(952) 443-4600
Mailing address
4315 GOLF CLUB DR APT 6511, AUBURN, AL 36830-5971
(952) 607-6479
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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