Healthcare Provider Details

I. General information

NPI: 1669500138
Provider Name (Legal Business Name): BARBARA DAWN KUTSI LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8747 LAMBERT RD
COTTON MN
55724-8008
US

IV. Provider business mailing address

8747 LAMBERT RD
COTTON MN
55724-8008
US

V. Phone/Fax

Practice location:
  • Phone: 218-393-2170
  • Fax:
Mailing address:
  • Phone: 218-393-2170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL 0369034-2
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: