Individual
KATHRYN ELIZABETH DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
17750 HUTCHINS DR., MINNETONKA, MN 55345
(952) 401-8300
(952) 401-8373
Mailing address
17750 HUTCHINS DR., MINNETONKA, MN 55345
(952) 401-8300
(952) 401-8373
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
20102395
MN
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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