Organization
KETAMINE NORTH
Active
Organization
KETAMINE NORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIE NICOLE JOHNSON CRNA (OWNER)
(507) 398-6313
Entity
Organization
Contact information
Practice address
1003 E CENTRAL ENTRANCE, DULUTH, MN 55811-5501
(218) 209-2150
Mailing address
1003 E CENTRAL ENTRANCE, DULUTH, MN 55811-5501
(218) 209-2150
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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