Individual
MS. KATHRYN MARIE DORR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2545 CHICAGO AVE, SUITE 500, MINNEAPOLIS, MN 55404-4522
(612) 863-7770
(612) 863-7772
Mailing address
3416 SKYCROFT DR, ST ANTHONY, MN 55418-1779
(612) 781-5234
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
8882
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116988D147
UCARE
MN
01
—
13T70GR
BLUE CROSS BLUE SHIELD
MN
01
—
1700668
MEDICA
MN
01
—
18390
HEALTHPARTNERS
MN
01
—
31732900
WISCONSIN MA
MN
05
—
886298200
—
MN
Enumeration date
05/18/2006
Last updated
04/30/2009
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