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General NPI Number Information
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NPI Number | 1568308146
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Entity Type | Individual
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Provider Name | AMY KAPAUN CARLSON
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Gender |
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 1 SCHOOL RD
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City | CIRCLE PINES
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State | MN
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Zip | 55014-1783
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Country | US
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Telephone | 763-792-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 2540 COUNTY ROAD F E
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-3935
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Country | US
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Telephone | 651-415-5510
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 200860
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License Number State | MN
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