Healthcare Provider Details

I. General information

NPI: 1720546773
Provider Name (Legal Business Name): ERIKA LINDSEY KUIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2019
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6469 SYCAMORE CT N
MAPLE GROVE MN
55369-6028
US

IV. Provider business mailing address

6469 SYCAMORE CT N
MAPLE GROVE MN
55369-6028
US

V. Phone/Fax

Practice location:
  • Phone: 763-276-9443
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6306
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: