Individual
KIMARA LINELL GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H
Contact information
Practice address
717 DELAWARE ST SE STE 353, MINNEAPOLIS, MN 55414-2959
(612) 624-1164
(612) 625-2920
Mailing address
3304 22ND AVE S, MINNEAPOLIS, MN 55407-5161
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
53893
MN
Other
Enumeration date
04/23/2009
Last updated
12/23/2019
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