Healthcare Provider Details

I. General information

NPI: 1205306867
Provider Name (Legal Business Name): KARI HOPE KJERGAARD OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2018
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 BARRIE RD STE 100
EDINA MN
55435-2364
US

IV. Provider business mailing address

6515 BARRIE RD STE 100
EDINA MN
55435-2364
US

V. Phone/Fax

Practice location:
  • Phone: 952-922-1384
  • Fax:
Mailing address:
  • Phone: 952-922-5019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0005261
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number105715
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: