Individual
KRISTINA NOWAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2310 PARK AVE NW, #203, FARIBAULT, MN 55021-9221
(612) 812-4417
Mailing address
2310 PARK AVE NW, #203, FARIBAULT, MN 55021-9221
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R161556-2
MN
Other
Enumeration date
07/22/2015
Last updated
07/22/2015
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