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Individual

ANNETTE W KUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
6025 LAKE RD, STE110, WOODBURY, MN 55125-1709
(651) 735-7414
(651) 735-1827
Mailing address
6025 LAKE RD, STE110, WOODBURY, MN 55125-1709
(651) 735-7414
(651) 735-1827

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R089470-8
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0407370
MEDICA
MN
01
1008767
AMERICA'S PPO
MN
01
132742
UCARE MN
MN
05
34860000
WI
05
831022000
MN
01
HP23673
HEALTHPARTNERS
MN
Enumeration date
03/14/2006
Last updated
11/17/2011
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