Kannon, Bodhi Kikue
Kannon, Bodhi Kikue is an individual health care provider with primary practice located at 480 Osborne Rd Ne Ste 260 , Fridley MN 55432-2866. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Kannon, Bodhi Kikue can be contacted via phone (763) 236-3800.Contact Information
Primary practice address
480 Osborne Rd Ne Ste 260
Fridley MN 55432-2866
Phone: (763) 236-3800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | MD00031094 | Washington |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 61296 | Minnesota |
Profile Details
| NPI number | 1740306240 |
|---|---|
| LBN Legal business name | Kannon, Bodhi Kikue |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2007 |
| Last updated | Mar 30th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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