Individual
DR. KATHLEEN ANN FAGERLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA, PHD
Contact information
Practice address
1 VETERANS DR # 112A, MINNEAPOLIS, MN 55417-2309
(612) 467-3392
(612) 467-5887
Mailing address
1880 NEWBERRY AVE N, STILLWATER, MN 55082-1705
(612) 467-3392
(612) 467-5887
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R104796-5
MN
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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