Healthcare Provider Details

I. General information

NPI: 1972668846
Provider Name (Legal Business Name): KATHRYN R ADAMS CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN R JOHNSON CPNP

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 COLBORNE ST
SAINT PAUL MN
55102-3228
US

IV. Provider business mailing address

360 COLBORNE ST
SAINT PAUL MN
55102-3228
US

V. Phone/Fax

Practice location:
  • Phone: 651-767-8189
  • Fax:
Mailing address:
  • Phone: 651-767-8189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number3151
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR130820-6
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: