Individual
MRS. KIM RENAE KUECHENMEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NA
Contact information
Practice address
323 SIXTH AVENUE, MADISION, MN 56256
(320) 598-7566
(320) 598-3760
Mailing address
323 SIXTH AVENUE, MADISION, MN 56256
(320) 598-7566
(320) 598-3760
Taxonomy
Speciality
Code
Description
License number
State
156FX1101X
Ophthalmic Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114995
UCARE MEDICAID
MN
05
—
166363100
—
MN
01
—
46044MA
BLUE PLUS MEDICAID
MN
Enumeration date
11/14/2006
Last updated
07/21/2022
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