Individual
KATHLEEN MARMORINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
HIGHWAY 1, BOX 497, RED LAKE, MN 56671-0497
(218) 679-3912
(218) 679-0181
Mailing address
HIGHWAY 1, BOX 497, RED LAKE, MN 56671-0497
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R 138537-1
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
387K5MA
BC/BS OF MN
MN
Enumeration date
07/03/2006
Last updated
11/08/2007
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