Individual
KAELEY THERESE WHITING ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
(218) 326-3401
Mailing address
1111 SW 22ND AVE, GRAND RAPIDS, MN 55744-9760
(218) 290-9562
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
66248
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2018
Last updated
03/10/2022
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