Individual
MARY FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
859 MANKATO AVE, WINONA CLINIC, WINONA, MN 55987
(507) 457-7667
(507) 457-7704
Mailing address
859 MANKATO AVE, WINONA CLINIC, WINONA, MN 55987
(507) 457-7667
(507) 457-7704
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0972002
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103827300
—
MN
Enumeration date
03/29/2006
Last updated
04/22/2008
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