Individual
KANEISHA MONIQUE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 NW 26TH ST, OWATONNA, MN 55060-5503
(507) 451-1120
Mailing address
2200 NW 26TH ST, OWATONNA, MN 55060-5503
(507) 451-1120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
72491
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
MS
Other
Enumeration date
05/06/2019
Last updated
03/10/2026
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