Individual
KEVIN KIPKOECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 GROTTO ST N, ST PAUL, MN 55104
(651) 760-3236
Mailing address
5381 MADISON ST NE, FRIDLEY, MN 55421-1259
(612) 961-8512
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
2461156
MN
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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