Healthcare Provider Details

I. General information

NPI: 1326367160
Provider Name (Legal Business Name): KRISTIN MARIT ENGLAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 WAYZATA BLVD STE 190
ST LOUIS PARK MN
55416-2627
US

IV. Provider business mailing address

PO BOX 1450, NW 5035
MINNEAPOLIS MN
55485-1450
US

V. Phone/Fax

Practice location:
  • Phone: 952-541-1840
  • Fax: 952-543-6524
Mailing address:
  • Phone: 952-542-8553
  • Fax: 952-513-6880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number65458
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: