Healthcare Provider Details

I. General information

NPI: 1164347415
Provider Name (Legal Business Name): KRISTIN KAMPMEYER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 FRANCE AVE S STE 210
EDINA MN
55435-2281
US

IV. Provider business mailing address

4917 EDEN AVE APT 509
EDINA MN
55424-2202
US

V. Phone/Fax

Practice location:
  • Phone: 952-928-2900
  • Fax: 952-928-2944
Mailing address:
  • Phone: 918-200-4889
  • Fax: 952-928-2944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1305607
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: