Individual
ANN M KOOIKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16201 90TH ST NE, SUITE 200, OTSEGO, MN 55330-7463
(763) 746-9492
(763) 746-3685
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
30772
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
645285000
—
MN
Enumeration date
05/09/2006
Last updated
09/24/2012
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