Healthcare Provider Details

I. General information

NPI: 1245676402
Provider Name (Legal Business Name): KATHERINE MARY NEU NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2013
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 DUCKWOOD DR # 200
EAGAN MN
55122-1451
US

IV. Provider business mailing address

1440 DUCKWOOD DR # 200
EAGAN MN
55122-1451
US

V. Phone/Fax

Practice location:
  • Phone: 651-203-4673
  • Fax:
Mailing address:
  • Phone: 651-276-2886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2119
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: