Healthcare Provider Details

I. General information

NPI: 1982518981
Provider Name (Legal Business Name): JENNY KRATOCHVIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 CHURCHILL ST W
STILLWATER MN
55082-6605
US

IV. Provider business mailing address

927 CHURCHILL ST W
STILLWATER MN
55082-6605
US

V. Phone/Fax

Practice location:
  • Phone: 651-430-4786
  • Fax:
Mailing address:
  • Phone: 651-430-4786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number2804
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: