Healthcare Provider Details

I. General information

NPI: 1801346093
Provider Name (Legal Business Name): CAROLINE KURIA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 05/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 UNIVERSITY AVE W FL 6
SAINT PAUL MN
55104-3727
US

IV. Provider business mailing address

45 10TH ST W
SAINT PAUL MN
55102-1062
US

V. Phone/Fax

Practice location:
  • Phone: 651-232-2273
  • Fax: 651-232-4953
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP 4798
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: