Individual
KRISTINE LEA STOMPRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1027 WASHINGTON AVENUE, EH ST MARY'S-DETROIT LAKES CLINIC URGENT CARE, DETROIT LAKES, MN 56501
(218) 847-5611
Mailing address
400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC MCL2CRED, DULUTH, MN 55805-1951
(218) 786-1183
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT-440
ID
363A00000X
Physician Assistant
Primary
12586
MN
Other
Enumeration date
08/14/2014
Last updated
11/14/2017
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