Individual
KELLY JON HARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DR.
Contact information
Practice address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 450-3986
(763) 450-3986
Mailing address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3221
MN
Other
Enumeration date
07/15/2025
Last updated
09/10/2025
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