Healthcare Provider Details

I. General information

NPI: 1811247786
Provider Name (Legal Business Name): KATHERINE HENTGES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 OSBORNE RD UNITY HOSPITAL
FRIDLEY MN
55432-2718
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 651-635-9173
  • Fax:
Mailing address:
  • Phone: 612-262-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0912017
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: