MEDICARE: DR. EMILLIE DEDON KIRVEN M.D.

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
1	208000000X	Pediatrics Physician	48664	MN

General Provider Information

NPI Number	:	1710044185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILLIE DEDON KIRVEN M.D.

Provider Business Mailing Address
First Line	:	4705 31ST AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3812
Country	:	US
Telephone Number	:	612-216-2137
Fax Number	:

Provider Business Practice Location Address
First Line	:	4705 31ST AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3812
Country	:	US
Telephone Number	:	612-216-2137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1801089024 — DR. BRUCE MERRTILL TENNEBAUM M.D.
Practice Location Address:

3812 ZENITH AVE S
MINNEAPOLIS, MN
55410-1167

Practice Phone: 612-929-8087
Practice Fax:

1972437838 — SCHULHOF HONEYCOMB PLLC
Practice Location Address:

4201 MINNEHAHA AVE
MINNEAPOLIS, MN
55406-3303

Practice Phone: 612-721-2833
Practice Fax:

1710364245 — ROGERS COUNSELING LLC
Practice Location Address:

3747 MINNEHAHA AVE STE 206
MINNEAPOLIS, MN
55406-2858

Practice Phone: 651-500-6827
Practice Fax:

1043526635 — JOHN ROGERS MA L.P.C.C.
Practice Location Address:

3747 MINNEHAHA AVE STE 206
MINNEAPOLIS, MN
55406-2858

Practice Phone: 651-500-6827
Practice Fax:

1467271981 — LAUREN GROSHEK MA
Practice Location Address:

2637 27TH AVE S STE 248
MINNEAPOLIS, MN
55406-1565

Practice Phone: 612-666-9002
Practice Fax:

1942561386 — DR. CARISSA LYNN BARNES D.C.
Practice Location Address:

3357 36TH AVE S
MINNEAPOLIS, MN
55406-2130

Practice Phone: 612-240-7133
Practice Fax: 612-233-5459

Directions to “ DR. EMILLIE DEDON KIRVEN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.