Individual
KYA MICHELLE HENNINGSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
20118 COUNTY ROAD 12, IRONTON, MN 56455-2048
(763) 221-1976
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9185
MN
Other
Enumeration date
05/22/2022
Last updated
08/24/2023
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