Individual
KATY JEAN SROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
520 NW 5TH ST, BRAINERD, MN 56401-2902
(218) 829-3235
Mailing address
520 NW 5TH ST, BRAINERD, MN 56401-2902
(218) 829-3235
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R 210000-5
MN
Other
Enumeration date
07/18/2016
Last updated
11/29/2018
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