Individual
KELSEY REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Mailing address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
6485
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6485
MN BOARD OF NURSING
MN
Enumeration date
03/18/2019
Last updated
03/18/2019
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