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Individual

SUSAN MARIE KOHLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1165 ARCADE ST, SAINT PAUL, MN 55106-2615
(651) 772-5555
(651) 772-5566
Mailing address
4639 PEGGY LN, WHITE BEAR LAKE, MN 55110-3335
(651) 429-5767

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0704782
MEDICA
MN
01
96G55KO
BCBS/BLUE PLUS
MN
01
HP65312
HEALTHPARTNERS
MN
01
NA4311047663
PREFERRED ONE
MN
Enumeration date
10/25/2006
Last updated
07/09/2007
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