Individual
JANE GRACE KILLGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5289
(218) 759-5021
Mailing address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5289
(218) 759-5021
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25351
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180800100
—
MN
Enumeration date
07/18/2006
Last updated
11/21/2011
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