Doctor Name: | KATHLEEN HALBERT |
NPI Number: | 1285094318 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | CNP-4291 |
Business Practice Address: | 200 Elm St N Onamia, MN - 563597901 |
Business Phone Number: | 3205323154 |
Business Fax Number: | |
Mailing Address: | Po Box 1154, BRAINERD |
State: | MN |
Postal Code: | 564011154 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/02/2016 |
NPI Last Update Date: | 03/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP-4291 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |