Individual
KATELIN SUPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN CNP
Contact information
Practice address
401 CARLSON PKWY, MINNETONKA, MN 55305-5359
(952) 992-3581
Mailing address
5320 W 23RD ST, STE 130, MINNEAPOLIS, MN 55416-1670
(952) 345-3213
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
PENDING
MN
Other
Enumeration date
07/28/2017
Last updated
07/21/2022
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