Healthcare Provider Details

I. General information

NPI: 1356254015
Provider Name (Legal Business Name): KAITLYN NICOLE ZLIMEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4402 HAINES RD STE 1
DULUTH MN
55811-2852
US

IV. Provider business mailing address

215 N 1ST AVE E APT 111
DULUTH MN
55802-2274
US

V. Phone/Fax

Practice location:
  • Phone: 651-214-7166
  • Fax:
Mailing address:
  • Phone: 651-214-7166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: