Provider Demographics
NPI:1457504870
Name:GLOOD, KRIS ANN
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:ANN
Last Name:GLOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:
Other - Last Name:MAASJO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 SMITH AVE
Mailing Address - Street 2:#500
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102
Mailing Address - Country:US
Mailing Address - Phone:651-292-0616
Mailing Address - Fax:651-726-7258
Practice Address - Street 1:225 SMITH AVE.
Practice Address - Street 2:#500
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-292-0616
Practice Address - Fax:651-726-7258
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology