Provider Demographics
NPI:1629327747
Name:JOHNKE-HENZLER, KARI LOUISE (RN)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:LOUISE
Last Name:JOHNKE-HENZLER
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:13911 RIDGEDALE DR
Mailing Address - Street 2:SUITE 484
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1771
Mailing Address - Country:US
Mailing Address - Phone:952-405-8812
Mailing Address - Fax:952-405-8820
Practice Address - Street 1:13911 RIDGEDALE DR
Practice Address - Street 2:SUITE 484
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1771
Practice Address - Country:US
Practice Address - Phone:952-405-8812
Practice Address - Fax:952-405-8820
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNR 196760-5163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse