Individual
MRS. KALLIE JO TEPOEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BSN, CRNA
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 697-5804
Mailing address
38548 OASIS RD, LINDSTROM, MN 55045-9637
(651) 235-3131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2280
MN
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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