Individual
KYLIE FLATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1614
MN
Other
Enumeration date
09/05/2011
Last updated
09/05/2011
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