Individual
MS. KILEY ELIZABETH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2545 CHICAGO AVE, SUITE 601, MINNEAPOLIS, MN 55404-4522
(612) 863-7770
(612) 863-7772
Mailing address
2545 CHICAGO AVE, SUITE 601, MINNEAPOLIS, MN 55404-4522
(612) 863-7770
(612) 863-7772
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R 1403224
MN
Other
Enumeration date
02/15/2007
Last updated
08/17/2010
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