Individual
KIMBERLY KAY THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 3RD ST SE, MINOT, ND 58701-3958
(701) 857-0773
Mailing address
225 3RD ST SE, MINOT, ND 58701-3958
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
ND
Enumeration date
02/05/2018
Last updated
02/05/2018
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