Provider Demographics
NPI:1225512254
Name:FINIFROCK, KATHARINE ANN (RN)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ANN
Last Name:FINIFROCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 COUNTY ROAD 6
Mailing Address - Street 2:
Mailing Address - City:BARNUM
Mailing Address - State:MN
Mailing Address - Zip Code:55707-8738
Mailing Address - Country:US
Mailing Address - Phone:612-655-5151
Mailing Address - Fax:
Practice Address - Street 1:60 ARROWHEAD LN
Practice Address - Street 2:
Practice Address - City:MOOSE LAKE
Practice Address - State:MN
Practice Address - Zip Code:55767-9453
Practice Address - Country:US
Practice Address - Phone:218-485-4401
Practice Address - Fax:218-485-8774
Is Sole Proprietor?:No
Enumeration Date:2018-09-15
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1884063163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice