Individual
JORDAN KRAAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2320 108TH AVE NW, COON RAPIDS, MN 55433-4115
(612) 396-2453
Mailing address
2320 108TH AVE NW, COON RAPIDS, MN 55433-4115
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13927
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/04/2020
Last updated
12/09/2021
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