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NPI Code Detail

MEDICARE: MRS. AMY KELLY DANIELSON KRIPPNER OTR/L

MEDICARE: MRS. AMY KELLY DANIELSON KRIPPNER OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist102487MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
164-05015OTHERMNMEDICA
2165554OTHERMNUCARE
3106177OTHERMNHEALTH PARTNERS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5412M2CHOTHERMNBLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number : 1134212707
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY KELLY DANIELSON KRIPPNER OTR/L
Provider Business Mailing Address
First Line : 312 4TH STREET SOUTHWEST
Second Line : SUITE 11
City : WILLMAR
State : MN
Zip : 56201
Country : US
Telephone Number : 320-214-7082
Fax Number : 320-235-8059
Provider Business Practice Location Address
First Line : 2653 COUNTY ROAD 74
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-2205
Country : US
Telephone Number : 320-420-4080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 09/01/2022

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