Healthcare Provider Details

I. General information

NPI: 1780507509
Provider Name (Legal Business Name): KATHERINE ALECIA RADCLIFFE-PAPAZIAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422-2926
US

IV. Provider business mailing address

17815 TIOGA TRL
WAYZATA MN
55391-3313
US

V. Phone/Fax

Practice location:
  • Phone: 763-520-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number195412-6
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: