Individual
KYLE ANDREW CAPONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 FIRST STREET SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 FIRST STREET SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14954
MN
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14954
STATE LICENSE
MN
Enumeration date
06/11/2024
Last updated
09/25/2024
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