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Individual

KENDRA J GRIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
49993
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
IA
05
ENROLLED
MN
05
ENROLLED
SD
05
ENROLLED
WI
Enumeration date
07/03/2007
Last updated
05/22/2013
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