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General NPI Number Information
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NPI Number | 1245075209
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Entity Type | Organization
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Legal Business Name | REDEFINE MENTAL HEALTH & WELLNESS, LLC
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Dates
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Enumeration Date | 07/01/2024
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1125 S FRONTAGE RD STE 6
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City | HASTINGS
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State | MN
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Zip | 55033-2489
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Country | US
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Telephone | 651-401-2533
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Fax | 651-252-1856
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Provider Business Mailing Address
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Address Line | 1303 S FRONTAGE RD STE 271
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City | HASTINGS
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State | MN
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Zip | 55033-2691
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Country | US
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Telephone | 612-503-2159
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Fax | 651-262-0016
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KARENA ROTHER
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Credential | MSN, APRN, PMHNP-BC
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Telephone | 612-503-2159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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