Individual
DR. JENNIFER MARLETTE KLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4194 LEXINGTON AVE N, SHOREVIEW, MN 55126-6106
(651) 483-5461
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
56190
MN
390200000X
Student in an Organized Health Care Education/Training Program
5101018349
MI
Other
Enumeration date
07/05/2009
Last updated
02/06/2015
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