Healthcare Provider Details

I. General information

NPI: 1861348021
Provider Name (Legal Business Name): KRYSTA LEA SZAJNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRYSTA LEA LITHERLAND

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 VIKING DR W
LITTLE CANADA MN
55117-1753
US

IV. Provider business mailing address

91 VIKING DR W
LITTLE CANADA MN
55117-1753
US

V. Phone/Fax

Practice location:
  • Phone: 651-696-5674
  • Fax: 651-698-2405
Mailing address:
  • Phone: 651-696-5674
  • Fax: 651-698-2405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13231
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: