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NPI Code Detail

MEDICARE: KRISTA J LOOP CFNP

MEDICARE: KRISTA J LOOP CFNP
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
1363LF0000XFamily Nurse PractitionerR1675696MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487629531
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTA J LOOP CFNP
Provider Business Mailing Address
First Line : 3300 FREMONT AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-2405
Country : US
Telephone Number : 612-588-9411
Fax Number : 612-588-8066
Provider Business Practice Location Address
First Line : 3300 FREMONT AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-2405
Country : US
Telephone Number : 612-588-9411
Fax Number : 612-588-8066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 03/10/2014

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