Individual
MRS. KAYLA LYNN BRUNKOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 335-2669
Mailing address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10640
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1086456
NCCPA CERTIFICATION NUMBER
MN
Enumeration date
09/10/2009
Last updated
10/21/2024
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