Doctor Name: | KRISTI L WENTWORTH |
NPI Number: | 1003128380 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | R 121580-7 |
Business Practice Address: | 725 Elm St Suite 1200 Alexandria, MN - 563081760 |
Business Phone Number: | 3207636018 |
Business Fax Number: | 3207634127 |
Mailing Address: | 725 Elm St, Suite 1200 ALEXANDRIA |
State: | MN |
Postal Code: | 563081760 |
Phone Number: | 3207636018 |
Fax Number: | 3207634127 |
NPI Enumeration Date: | 07/02/2010 |
NPI Last Update Date: | 07/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | R 121580-7 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |