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Individual

KATHLEEN D HENKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R-144717-0
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
497432800
MN
05
ENROLLED
ID
05
ENROLLED
SD
05
ENROLLED
WI
01
P00319413
RAILROAD MEDICARE
MN
Enumeration date
02/13/2006
Last updated
03/12/2014
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