Healthcare Provider Details

I. General information

NPI: 1477858587
Provider Name (Legal Business Name): KRISTEL A ST. ORES RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2011
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 WABASHA ST HEALTHPARTNERS ST. PAUL URGENT CARE
ST. PAUL MN
55107-1805
US

IV. Provider business mailing address

8170 33RD AVE S MS21110Q
MINNEAPOLIS MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 952-853-8800
  • Fax: 651-293-8106
Mailing address:
  • Phone: 952-883-5375
  • Fax: 651-293-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR 152621-1
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: