Individual
MRS. ALLYSSA MAE KITTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5400 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416-2913
(952) 993-1000
(952) 993-1160
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/03/2014
Last updated
06/29/2022
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