Individual
KIMBERLY M KENIRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805
(218) 786-8364
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4222
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
65105
MN
208100000X
Physical Medicine & Rehabilitation Physician
66340
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346668183
—
WI
Enumeration date
03/30/2014
Last updated
05/22/2019
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