Healthcare Provider Details

I. General information

NPI: 1770019002
Provider Name (Legal Business Name): MEGHAN KINSEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 N FRONTAGE RD
HASTINGS MN
55033-2687
US

IV. Provider business mailing address

1880 N FRONTAGE RD
HASTINGS MN
55033-2687
US

V. Phone/Fax

Practice location:
  • Phone: 651-438-1800
  • Fax:
Mailing address:
  • Phone: 651-438-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number67003
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: