Individual
MS. KATHRYN SUSAN EISENMENGER FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2854 HIGHWAY 55, SUITE 130, EAGAN, MN 55121-2156
(651) 842-3320
(651) 224-5273
Mailing address
2854 HIGHWAY 55, SUITE 130, EAGAN, MN 55121-2156
(651) 842-3320
(651) 224-5273
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1514
MN
Other
Enumeration date
12/09/2010
Last updated
12/13/2010
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