Most Relevant Information
Provider Data
| NPI Number: | 1003290685 |
| Provider Name: | KENNETH MCRAE DNP, APRN, CNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 3895 |
Most Important Dates
| Enumeration Date: | 07/14/2015 |
| Last Updated: | 06/26/2023 |
Provider Practice Location
2925 CHICAGO AVE
MINNEAPOLIS
MN
55407
Practice Location Phone/Fax
| Phone: | 7632365000 |
| Fax: |
Provider Mailing Location
5829 44TH AVE SOUTH
MINNEAPOLIS
MN
554172718
Provider Mailing Phone/Fax
| Phone: | 6128171211 |
| Fax: |