Individual
JOY MICHELLE KOTASEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
206 5TH AVE NW, NEW PRAGUE, MN 56071-1222
(612) 598-4944
Mailing address
206 5TH AVE NW, NEW PRAGUE, MN 56071-1222
(612) 598-4944
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L048257-6
MN
Other
Enumeration date
04/05/2012
Last updated
04/05/2012
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