Healthcare Provider Details

I. General information

NPI: 1467384206
Provider Name (Legal Business Name): COURTNEY JEAN KUTZLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 3RD AVE S STE 100
MINNEAPOLIS MN
55401-2551
US

IV. Provider business mailing address

111 3RD AVE S STE 100
MINNEAPOLIS MN
55401-2551
US

V. Phone/Fax

Practice location:
  • Phone: 507-782-1327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number31160
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: