Healthcare Provider Details

I. General information

NPI: 1912271180
Provider Name (Legal Business Name): KARI PRESCOTT DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2012
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NICOLLET MALL STE 441
MINNEAPOLIS MN
55402-2611
US

IV. Provider business mailing address

825 NICOLLET MALL STE 441
MINNEAPOLIS MN
55402-2611
US

V. Phone/Fax

Practice location:
  • Phone: 612-338-4731
  • Fax: 612-886-1729
Mailing address:
  • Phone: 612-338-4731
  • Fax: 612-886-1729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number683
License Number StateMN

VIII. Authorized Official

Name: DR. KARI E PRESCOTT
Title or Position: OWNER/PHYSICIAN
Credential: DPM
Phone: 612-338-4731