Individual
KRISTIN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
1108 1ST ST SE, LITTLE FALLS, MN 56345-3440
(320) 632-3671
(320) 632-3728
Mailing address
1108 1ST ST SE, LITTLE FALLS, MN 56345-3440
(320) 632-3671
(320) 632-3728
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
612
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
967750000MN
—
MN
Enumeration date
05/08/2006
Last updated
02/05/2008
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