Individual
KIMBERLY DE PAULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 NW 26TH ST, OWATONNA, MN 55060
(507) 451-1120
Mailing address
2200 NW 26TH ST, OWATONNA, MN 55060-5503
(507) 451-1120
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2445948
MN
363L00000X
Nurse Practitioner
Primary
5070
MN
363L00000X
Nurse Practitioner
R204304
MD
Other
Enumeration date
06/28/2016
Last updated
10/05/2020
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