Provider Demographics
NPI:1629745070
Name:PERSING, KATHERINE (RN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:PERSING
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 1:245 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-3467
Mailing Address - Country:US
Mailing Address - Phone:612-870-3787
Mailing Address - Fax:612-870-3789
Practice Address - Street 1:245 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3467
Practice Address - Country:US
Practice Address - Phone:612-870-3787
Practice Address - Fax:612-870-3789
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN206660-2163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse