Individual
MS. KIMBERLY F LAXMANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3960 COON RAPIDS BLVD NW, SUITE 101, COON RAPIDS, MN 55433-2569
(763) 236-9236
Mailing address
3960 COON RAPIDS BLVD NW, SUITE 101, COON RAPIDS, MN 55433-2569
(763) 236-9236
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
LAX-1-0434-0626
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LAX-1-0434-0626
NATIONAL CERTIFICATION CORPORATION, NP LICENSE
MN
Enumeration date
10/08/2009
Last updated
03/11/2021
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