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Individual

MRS. KIMBERLY RAE THEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, FNP

Contact information

Practice address
10000 ZANE AVE N, BROOKLYN PARK, MN 55369
(763) 528-6999
Mailing address
14760 91ST AVE N, MAPLE GROVE, MN 55369-8302
(910) 322-6671

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
142519
NC
363LF0000X
Family Nurse Practitioner
Primary
R100061 4
MN

Other

Enumeration date
03/14/2006
Last updated
06/25/2013
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