Individual
KAY T WASYLISZYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, AGNP-C, CNP, RN
Contact information
Practice address
480 OSBORNE RD NE STE 220, FRIDLEY, MN 55432-2866
(763) 786-1620
(763) 780-3099
Mailing address
574 MARSHALL AVE, SAINT PAUL, MN 55102-1723
(651) 253-4792
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
10702
MN
363LG0600X
Gerontology Nurse Practitioner
10702
MN
363LP2300X
Primary Care Nurse Practitioner
Primary
10702
MN
Other
Enumeration date
09/07/2023
Last updated
10/16/2023
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