Healthcare Provider Details

I. General information

NPI: 1861105090
Provider Name (Legal Business Name): KRISTIE WESTERBECK DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 RIVERSIDE AVE
MINNEAPOLIS MN
55454-1350
US

IV. Provider business mailing address

4516 W 88TH ST
BLOOMINGTON MN
55437-1402
US

V. Phone/Fax

Practice location:
  • Phone: 612-330-1000
  • Fax:
Mailing address:
  • Phone: 651-235-6689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7044
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: