=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215592068
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADRIENNE ELIZABETH SUESS L.AC, DIPL.AC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2019
-----------------------------------------------------
Last Update Date | 09/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12455 RIDGEDALE DR
-----------------------------------------------------
City | MINNETONKA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55305-1786
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-314-7035
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12455 RIDGEDALE DR
-----------------------------------------------------
City | MINNETONKA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55305-1786
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-314-7038
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 1910
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------