Individual
KIMBERLY M DYLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4222
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA419
MN
Other
Enumeration date
10/23/2006
Last updated
05/10/2018
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