Individual
MRS. KAY VAN ALTUORST HERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1015 MARSH ST, MANKATO, MN 56001-4752
(507) 389-4700
Mailing address
1200 6TH AVE N, CENTRACARE CLINIC, SAINT CLOUD, MN 56303-2735
(320) 252-3342
(507) 389-4885
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10193
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240633000
—
MN
Enumeration date
08/30/2006
Last updated
12/11/2013
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