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Individual

KENDRA MCKAY LYSTAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3000
Mailing address
PO BOX 66308, HOUSTON, TX 77266-6308
(832) 548-5000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9195404
UT
208000000X
Pediatrics Physician
Primary
S1645
TX
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
S1645
TX

Other

Enumeration date
03/21/2013
Last updated
07/29/2024
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