Healthcare Provider Details

I. General information

NPI: 1689607673
Provider Name (Legal Business Name): KATHLEEN SHIELDS LINNEMANN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN SHIELDS STEPANIAK M.D.

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 1ST ST NE
FARIBAULT MN
55021-5441
US

IV. Provider business mailing address

PO BOX 860912
MINNEAPOLIS MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 507-333-3300
  • Fax: 507-333-3214
Mailing address:
  • Phone: 507-284-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number103047
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number44838
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: