Individual
KRISTY LEIGH ICEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2560 RIDGEWAY AVE NW, BEMIDJI, MN 56601-2149
(218) 214-0752
Mailing address
2560 RIDGEWAY AVE NW, BEMIDJI, MN 56601-2149
(218) 214-0752
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
MN
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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