Individual
MAMMARIE KAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
Mailing address
1200 6TH AVE N, ST. CLOUD, MN 56303
(320) 240-2206
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4497
MN
363LA2200X
Adult Health Nurse Practitioner
4497
MN
363LG0600X
Gerontology Nurse Practitioner
4497
MN
Other
Enumeration date
05/02/2016
Last updated
03/27/2023
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