Individual
STACEY KEHOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
308 2ND AVE, JOHNSON, MN 56236-2105
(320) 305-0856
Mailing address
308 2ND AVE, JOHNSON, MN 56236-2105
(320) 305-0856
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
3747P1801X
MN
Other
Enumeration date
11/30/2006
Last updated
07/09/2007
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