Healthcare Provider Details

I. General information

NPI: 1639503865
Provider Name (Legal Business Name): MEGAN ELIZABETH SIMMONS KIEFER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2013
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MOULTON AND PARSONS DR
SAINT JAMES MN
56081-5550
US

IV. Provider business mailing address

PO BOX 860912
MINNEAPOLIS MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 507-375-3391
  • Fax:
Mailing address:
  • Phone: 507-375-3391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number51216
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number72490
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: