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General NPI Number Information
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NPI Number | 1588548812
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Entity Type | Individual
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Provider Name | KIRSTEN MARIE DEHAVEN DC
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 2822 W 43RD ST STE 100
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City | MINNEAPOLIS
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State | MN
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Zip | 55410-1696
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Country | US
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Telephone | 612-767-4680
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 CEDAR LAKE RD S APT 517
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-5328
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Country | US
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Telephone | 612-242-7724
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7368
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License Number State | MN
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