Doctor Name: | MARY ELIZABETH KLEINGARN |
NPI Number: | 1871842203 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 13603 80th Circle North Maple Grove, MN - 55369 |
Business Phone Number: | 7632743120 |
Business Fax Number: | |
Mailing Address: | 1900 Silver Lake Road Nw, Suite 110 NEW BRIGHTON |
State: | MN |
Postal Code: | 55112 |
Phone Number: | 6513791718 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2012 |
NPI Last Update Date: | 01/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |