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General NPI Number Information
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NPI Number | 1326609116
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Entity Type | Individual
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Provider Name | KRISTEN MARIE NAASZ PA
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Gender | Female
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 7362 UNIVERSITY AVE NE
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City | FRIDLEY
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State | MN
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Zip | 55432-3142
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Country | US
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Telephone | 612-230-8154
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 W 66TH ST STE 265
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City | EDINA
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State | MN
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Zip | 55435-2173
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Country | US
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Telephone | 612-230-8696
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 13047
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License Number State | MN
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