Healthcare Provider Details

I. General information

NPI: 1447166434
Provider Name (Legal Business Name): KAITLYN FIELDS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11850 BLACKFOOT ST NW STE 400
COON RAPIDS MN
55433-2776
US

IV. Provider business mailing address

11850 BLACKFOOT ST NW
COON RAPIDS MN
55433-2578
US

V. Phone/Fax

Practice location:
  • Phone: 763-236-8911
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number14526
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: