Individual
KRISTIN M DETTMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
345 NORTH SMITH AVE, CHILDRENS HOSPITALS AND CLINICS OF MINNESOTA, ST PAUL, MN 55102
(651) 220-6914
Mailing address
2910 CENTRE POINTE DR 35-121A, CHILDRENS HEALTH CARE, ROSEVILLE, MN 55113
(651) 855-2327
(651) 855-2310
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
357
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
797603800
—
MN
Enumeration date
11/01/2006
Last updated
11/12/2024
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