Individual
KATHY ANN MAINELLA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
167 FARLEY LN, DULUTH, MN 55803-1526
(218) 724-0343
Mailing address
167 FARLEY LN, DULUTH, MN 55803-1526
(218) 724-0343
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
234054
MN
Other
Enumeration date
03/11/2018
Last updated
03/11/2018
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