Individual
KEVIN CARLYLE LUNDE X
Active
Individual
KEVIN CARLYLE LUNDE X
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093031-1-AFC
DEPARTMENT OF HUMAN SERVICES
MN
01
—
RV934R
PROVIDER
MN
Enumeration date
05/13/2019
Last updated
05/13/2019
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