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General NPI Number Information
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NPI Number | 1366182370
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Entity Type | Individual
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Provider Name | KIMBERLY A PERRINE CHC
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Gender | Female
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Dates
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Enumeration Date | 03/29/2022
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Last Update Date | 10/05/2024
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Provider Practice Location Address
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Address Line | 7500 GOLDEN TRIANGLE DR UNIT G11
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-3860
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Country | US
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Telephone | 612-323-5000
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Fax | 952-888-1134
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Provider Business Mailing Address
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Address Line | 13111 BAKER TRL
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City | MINNETONKA
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State | MN
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Zip | 55305-5017
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Country | US
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Telephone | 161-232-3500
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Fax | 952-888-1134
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | MN
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