Individual
CAROLYN KEUP WEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
12755 HIGHWAY 55, MN009-S130, PLYMOUTH, MN 55441-3837
(800) 896-8936
(888) 866-3209
Mailing address
17000 19TH AVE N, PLYMOUTH, MN 55447-2739
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R0932123
MN
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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