Individual
GINA ANN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 1ST AVE NE, BUFFALO, MN 55313-1568
(763) 682-3005
Mailing address
25 1ST AVENUE NE, BUFFALO, MN 55313
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L 57243-1
MN
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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