Individual
KYLIE VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3937 YOSEMITE AVE S, SAINT LOUIS PARK, MN 55416-2821
(612) 275-9155
Mailing address
3937 YOSEMITE AVE S, SAINT LOUIS PARK, MN 55416-2821
(612) 275-9155
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
204856-5
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
204856-5
MN
Other
Enumeration date
11/11/2016
Last updated
02/03/2017
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