Healthcare Provider Details

I. General information

NPI: 1366868754
Provider Name (Legal Business Name): KAREN TRUTNAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 11/29/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7235 OHMS LN
EDINA MN
55439-2148
US

IV. Provider business mailing address

7235 OHMS LN
EDINA MN
55439-2148
US

V. Phone/Fax

Practice location:
  • Phone: 952-841-2345
  • Fax: 952-841-2346
Mailing address:
  • Phone: 952-841-2345
  • Fax: 952-841-2346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR1858277
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: