Individual
MS. MICHELLE KIENOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2720 FAIRVIEW AVE N # 200, ROSEVILLE, MN 55113-1306
(651) 633-6883
Mailing address
611 4TH ST, WAUNAKEE, WI 53597-1233
(608) 228-1266
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/20/2021
Last updated
06/06/2023
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