NPI Code Details Logo

NPI 1245676402

NPI 1245676402 : KATHERINE MARY NEU NP-C : EAGAN, MN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1245676402
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KATHERINE MARY NEU NP-C
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/15/2013
-----------------------------------------------------
    Last Update Date     |    05/03/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1440 DUCKWOOD DR # 200 
-----------------------------------------------------
    City                 |    EAGAN
-----------------------------------------------------
    State                |    MN
-----------------------------------------------------
    Zip                  |    55122-1451
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    651-203-4673
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1440 DUCKWOOD DR # 200 
-----------------------------------------------------
    City                 |    EAGAN
-----------------------------------------------------
    State                |    MN
-----------------------------------------------------
    Zip                  |    55122-1451
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    651-276-2886
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LF0000X
-----------------------------------------------------
    Taxonomy Name        |    Family Nurse Practitioner
-----------------------------------------------------
    License Number       |    2119
-----------------------------------------------------
    License Number State |    MN
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.