Individual
KATHLEEN UDOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
624 13TH ST S, VIRGINIA, MN 55792-3149
(218) 749-2881
Mailing address
507 E HARVEY ST, ELY, MN 55731-1445
(218) 235-1108
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9004
MN
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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